Turning the spotlight on sexually transmitted infections

Abstract

Sexually transmitted infections (STIs) represent a heterogeneous group of infections that affect millions of people, including key populations such as sex workers, men who have sex with men, and people who inject drugs. Among them, chlamydia infection and bacterial vaginosis are very common problems, especially in women; it is estimated that one of 12 people in the world has genital infection with herpes simplex virus; the number of cases of syphilis and gonorrhoea is increasing worldwide; and there is an intense debate on how interventions to prevent HIV infection, such as pre-exposure prophylaxis and post-exposure prophylaxis, might have a negative effect on risk taking when it comes to sexual behaviour. Moreover, besides the immediate effect on the health of the infected person, STIs can also lead to infertility, miscarriage, stillbirth, and transmission from mother to child. Overall, WHO estimated that one million new cases of STIs (chlamydia, gonorrhoea, syphilis, and trichomoniasis) occur every day. 1 Newman L Rowley J Vander Hoorn S et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PLoS One. 2015; 10: e0143304 Google Scholar Although this number should be hard to ignore, these infections remain a neglected issue in both the public health agenda and the research community. Sexually transmitted infections: challenges aheadWHO 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. Full-Text PDF Mycoplasma genitalium: yet another challenging STIIn The Lancet Infectious Diseases, Unemo and colleagues1 present a well written and comprehensive Commission on the “challenges ahead” for sexually transmitted infections (STIs). The authors address many issues around some of the most important STIs, such as Chlamydia trachomatis and Neisseria gonorrhoeae, the two most common bacterial STIs globally according to WHO estimates.2 They also address bacterial vaginosis, which is the most prevalent urogenital condition in women worldwide. Although not covered in the Commission because of the availability of recent reviews,3,4 Mycoplasma genitalium infection is a bacterial STI second in prevalence only to C trachomatis in most studies. Full-Text PDF Challenges in responses to syphilis epidemicA decrease in the global estimate of four curable sexually transmitted infections (STIs), including chlamydia, gonorrhoea, trichomoniasis, and syphilis, was observed in 2012 by comparison with that of 2008, but 2015 saw an estimated 357 million new cases for the four infections combined.1 This overall decrease mainly reflects the contribution of the reduction of syphilis seropositivity among pregnant women over time in countries that consistently report seropositivity data to WHO.2 Full-Text PDF Health systems and the new strategy against sexually transmitted infectionsThe Lancet Infectious Diseases Commission by Unemo and colleagues1 on sexually transmitted infections (STIs) is published at an important time in the global public health response to STIs. STIs are important causes of morbidity and mortality. WHO estimated that about 357·4 million new cases of chlamydia, gonorrhoea, syphilis, and trichomoniasis occur annually.2 Viral STIs are also highly prevalent with an estimated 417 million people infected with herpes simplex virus type 2 and approximately 291 million women with human papillomavirus (HPV) infections. Full-Text PDF