Summary Male sex workers (MSW) who sell/exchange sex for money or goods comprise an extremely diverse population across and within countries worldwide. Information characterizing their practices, contexts where they live, and their needs is very limited, as these men are generally included as subsets of larger studies focused on gay men and other men who have sex with men (MSM) or even female sex workers. MSW, regardless of their sexual orientation, mostly offer sex to men, and rarely identify as sex workers, using local or international terms instead. There is growing evidence of a sustained or increasing burden of HIV among some MSW in the context of the slowing global HIV pandemic. There are several synergistic facilitator spotentiating HIV acquisition and transmission among MSW, including biological, behavioural, and structural determinants. The criminalization and intersectional stigmas of same-sex practices, commercial sex, and HIV all increase HIV and STI risk for MSW and decrease their likelihood of accessing essential services. These contexts, taken together with complex sexual networks among MSW, define them as a key population underserved by current HIV prevention, treatment, and care services. Dedicated efforts are needed to make those services available for the sake of both public health and human rights.

A randomized controlled trial of the efficacy and safety of a fixed triple combination (fluocinolone acetonide 0AE01%, hydroquinone 4%, tretinoin 0AE05%) compared with hydroquinone 4% cream in Asian patients with moderate to severe melasma R. Chan, K.C. Park,* M.H. Lee, E-S. Lee SummaryBackground Melasma is an acquired, chronic hypermelanosis for which therapy remains a challenge. Objectives To compare the efficacy and safety of a triple combination [TC: fluocinolone acetonide 0AE01%, hydroquinone (HQ) 4%, tretinoin 0AE05%] vs. HQ 4% after 8 weeks of treatment of moderate to severe facial melasma in Asian patients. Methods This was a multicentre, randomized, controlled, investigator-blinded, parallel comparison study. East and South-East Asian patients aged 18 years or older, with a clinical diagnosis of moderate to severe melasma, were enrolled in this study. Patients were enrolled at baseline and treated daily for 8 weeks with TC cream (one application at bedtime) or HQ cream (twice daily). There were four study visits: at baseline and weeks 2, 4 and 8. The primary efficacy variable was the melasma global severity score (GSS). Other outcome measures included Melasma Area and Severity Index, global improvement and patient satisfaction. Safety was assessed through the reporting of adverse events. Results TC had superior efficacy to HQ for the primary variable: 77 ⁄120 patients (64AE2%) on TC had GSS 'none' or 'mild' at week 8 vs. 48 ⁄122 patients (39AE4%) on HQ (P < 0AE001). The secondary efficacy variables confirmed these results. Patient satisfaction was in favour of TC (90 ⁄127, 70AE8%, vs. 64 ⁄129, 49AE6%; P = 0AE005). More patients had related adverse events on TC (63 ⁄129, 48AE8%) than on HQ (18 ⁄131, 13AE7%) but most were mild and none was severe. Conclusions Efficacy in Asians and patient satisfaction were superior with the fixed TC than with HQ 4%.

A preponderance of inflammatory dermatoses and an absence of skin tumors characterized this study. A low CD4 cell count was associated with a higher number of skin disorders and an increased incidence of PPE, psoriasis, and adverse drug eruptions.

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