{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:06:03Z","timestamp":1789200363643,"version":"build-2803163510"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01 AI149339"],"award-info":[{"award-number":["R01 AI149339"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Clinician-observed external genital lesions may be incorporated into syndromic STI management, yet their prevalence and morphology in antenatal populations are poorly characterized. We aimed to describe the prevalence and types of clinician-observed genital lesions among pregnant women in a high HIV\/STI prevalence setting and examine their distribution by laboratory-confirmed HIV, syphilis, and\n                      <jats:italic toggle=\"yes\">Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis (CT\/NG\/TV<\/jats:italic>\n                      ) status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed clinical and laboratory data from the Philani Ndiphile antenatal STI screening study (2021\u20132025), conducted across four primary healthcare clinics in the Eastern Cape, South Africa (ClinicalTrials.gov identifier: NCT04446611). Among 2,247 pregnant women attending their first antenatal visit, trained clinicians documented the presence and morphology of external genital lesions during routine pelvic examination. Lesions were categorized as warts, inflammatory\/dermatitis-like, ulcerative\/erosive, boils\/abscesses, scarring, cystic swelling, or other\/unclassified. HIV and syphilis were diagnosed using rapid antibody testing and rapid treponemal tests;\n                      <jats:italic toggle=\"yes\">CT\/NG\/TV<\/jats:italic>\n                      was detected by GeneXpert\u00ae molecular assay. Analyses used counts and proportions to characterize lesion prevalence overall and by infection status, with comparisons performed separately for HIV, syphilis, and\n                      <jats:italic toggle=\"yes\">CT\/NG\/TV<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 61 participants (2.7%) had a clinician-observed genital lesion. Lesion prevalence was significantly higher among women living with HIV than among women without HIV (6.1% vs. 1.3%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001) and among women with, versus women without syphilis (11.9% vs. 2.4%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), but did not differ significantly between women with versus without\n                      <jats:italic toggle=\"yes\">CT\/NG\/TV<\/jats:italic>\n                      (3.5% vs. 2.4%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.16). Warts were the most common lesion type overall and were disproportionately observed among women living with HIV. Among lesion-positive women within each infection group, ulcerative lesions were observed in 40% of those with syphilis, 12.5% of those living with HIV, and 19% of those with\n                      <jats:italic toggle=\"yes\">CT\/NG\/TV<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinician-observed genital lesions were uncommon in this antenatal cohort, and most laboratory-confirmed STIs were not accompanied by visible lesions. These findings highlight their limited overlap and support current guidelines emphasizing laboratory-based antenatal screening for HIV and syphilis, with expanded STI testing where diagnostic capacity permits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624261487933","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T20:04:22Z","timestamp":1788984262000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinician-observed genital lesions among pregnant women in a high HIV\/sexually transmitted infection prevalence setting"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8763-1860","authenticated-orcid":false,"given":"Chinazo","family":"Onyema","sequence":"first","affiliation":[{"name":"University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chibuzor M.","family":"Babalola","sequence":"additional","affiliation":[{"name":"University of Southern California, Los Angeles, California, USA"},{"name":"University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6922-7364","authenticated-orcid":false,"given":"Jeffrey","family":"Klausner","sequence":"additional","affiliation":[{"name":"University of Southern California, Los Angeles, California, USA"},{"name":"University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/09564624251347484"},{"issue":"1","key":"e_1_3_4_3_2","first-page":"312","article-title":"Sexually transmitted infections in pregnant women from Sub-Saharan Africa","volume":"36","author":"Ngobese B","year":"2021","unstructured":"Ngobese B, Abbai NS. Sexually transmitted infections in pregnant women from Sub-Saharan Africa. S Afr J Infect Dis 2021; 36(1): 312. https:\/\/doi.org\/10.4102\/sajid.v36i1.312","journal-title":"S Afr J Infect Dis"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052367"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052581"},{"key":"e_1_3_4_6_2","volume-title":"Guidelines for the management of symptomatic sexually transmitted infections","author":"World Health Organization","year":"2021","unstructured":"World Health Organization. Guidelines for the management of symptomatic sexually transmitted infections. World Health Organization, 2021."},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30724-2"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/6203193"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae104"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004385"},{"key":"e_1_3_4_11_2","doi-asserted-by":"crossref","unstructured":"Medina-Marino A Babalola CM Mdingi MM et al. Antenatal screening for sexually transmitted infections to reduce preterm birth or low birthweight (philani ndiphile study): a randomized three-group trial. medRxiv 2026 [Preprint]. 2026.04.15.26350805.","DOI":"10.64898\/2026.04.15.26350805"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001765"},{"issue":"1","key":"e_1_3_4_13_2","first-page":"1450","article-title":"Southern African HIV clinicians society 2022 guideline for the management of sexually transmitted infections: moving towards best practice","volume":"23","author":"Peters RPH","year":"2022","unstructured":"Peters RPH, Garrett N, Chandiwana N, et al. Southern African HIV clinicians society 2022 guideline for the management of sexually transmitted infections: moving towards best practice. South Afr J HIV Med. 2022; 23(1): 1450. https:\/\/doi.org\/10.4102\/sajhivmed.v23i1.1450","journal-title":"South Afr J HIV Med"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261487933","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624261487933","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261487933","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T07:18:52Z","timestamp":1789197532000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624261487933"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":12,"alternative-id":["10.1177\/09564624261487933"],"URL":"https:\/\/doi.org\/10.1177\/09564624261487933","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"09564624261487933"}}