Epidemiology Of Sexually Transmitted Infections Research Articles

Sexually transmitted pathogens in asymptomatic women at Rethabile clinic, Limpopo, South Africa.

Health care for sexually transmitted infections (STIs) is often inadequate, especially for women, because of the asymptomatic nature of many STIs, which can lead to a false sense of health. Thus, there is limited data on the prevalence of STIs in pregnant women in low and middle-income countries. The study aimed to determine the prevalence of STIs in asymptomatic pregnant women attending antenatal Rethabile Community Health Centre, Limpopo, South Africa. A cross-sectional analysis of asymptomatic pregnant women at Rethabile Community Health Centre between March 2023 and November 2023 was conducted to determine the prevalence of seven STIs, detected from self-collected vaginal swab specimens using HAIN fluoroType STI-multiplex Polymerase Chain Reaction (PCR) test for nine targets covering seven major STIs. The study found that Ureaplasma urealyticum was the most prevalent pathogen (43%) followed by Chlamydia trachomatis (41%), and Trichomonas vaginalis (10%). The less common pathogens detected were Mycoplasma Genitalium (5%) and Neisseria gonorrhoeae (2%). High STI prevalence among asymptomatic pregnant women at Rethabile Community Health Centre necessitates diagnostic screening over syndromic management because of a lack of reporting for symptoms. The paper examines the epidemiology of STIs in Limpopo, South Africa, focusing on healthy, asymptomatic populations. It emphasises the need for laboratory screening, particularly in pregnant women, over empiric treatment because of high chances of missing infections.

Sexually transmitted infections in the middle east and North Africa: comprehensive systematic review and meta-analysis

BackgroundGlobally, sexually transmitted infections (STIs) collectively cause 2.3 million deaths and 1.2 million cases of cancer annually. However, the epidemiology of STIs in the Middle East and North Africa (MENA) is not well assessed because of various social and cultural factors.MethodsA systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and covering 23 MENA countries, 19 STIs, and data from 20,435,971 participants. PubMed, Embase, regional and international databases, and country-level reports were searched up to May 2024.ResultsThe analysis revealed significant regional variations in the prevalence of STIs within the MENA region. In North Africa, the most common STIs were bacterial vaginosis (31%), human papillomavirus (HPV, 23%), and Candida spp. (15%). In the Gulf Cooperation Council region and Yemen, Ureaplasma (25%), nongonococcal urethritis (NGU, 16%), and Mycoplasma spp. (12%) were the predominant infections. In the Levant region, the top STIs were HPV (20%), hepatitis B virus (HBV, 9%), and Candida spp. (9%). In Iran, Ureaplasma spp. (18%), HPV (17%), and cytomegalovirus (8%) were the most prevalent infections, whereas Ureaplasma spp. (20%), Candida spp. (18%), and HPV (16%) were most frequently detected in Türkiye. Gender-based disparities were observed, with a higher prevalence of Ureaplasma spp., Neisseria gonorrhoeae, and herpes in men and higher rates of Mycoplasma spp., HPV, HBV, and Candida spp. in women. Overall, high rates of nongonococcal urethritis (16.3%), Ureaplasma spp. (13.7%), HPV (12.7%), and Candida spp. (9.4%) were recorded in the MENA region.ConclusionsMost MENA countries lack national STI screening programs, and the reported data are primarily from symptomatic individuals. Establishing robust surveillance systems, addressing stigma and barriers to healthcare access, and expanding STIs screening and vaccination programs are crucial for accurately capturing the true burden of STIs in MENA countries.

The Prevalence of Sexually Transmitted Infections among Male Patients at a Dermato-Venereology Outpatient Clinic in Gdańsk, Poland: Findings from a Single-Center Study.

Background: Sexually transmitted infections (STIs) are a significant public health concern worldwide, yet data on their prevalence and epidemiology, particularly in Central and Eastern Europe, remain scarce. This study aimed to assess the prevalence, anatomical localization, symptomatic/asymptomatic course, and co-infection patterns of STIs among men. Methods: This retrospective study analyzed data collected between May 2021 and July 2023, including sociodemographic, sexual behavior, and clinical data from 139 male participants. Molecular polymerase chain reaction (PCR) tests were conducted for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Mycoplasma genitalium, and Trichomonas vaginalis. Results: Of the participants, 36% tested positive for at least one STI, with the urethra being the most common site of infection. NG and CT were the most prevalent infections. The majority of infections were asymptomatic, highlighting the importance of comprehensive screening, especially in high-risk populations like men who have sex with men (MSM). Conclusions: This study emphasizes the need for targeted screening strategies, particularly for extragenital STIs, and underscores the role of MSM in STI epidemiology. The findings highlight the importance of routine screening, even for asymptomatic individuals, to effectively control STI spread. Future research should validate and expand upon these findings to enhance STI prevention and management efforts.

Determining the screening frequency for sexually transmitted infections for people who use HIV pre-exposure prophylaxis: a systematic review and meta-analysis

Although the World Health Organization recommends 'frequent' screening of sexually transmitted infections (STI) for people who use pre-exposure prophylaxis for HIV, there is no evidence for optimal frequency. We searched five databases and used random-effects meta-analysis to calculate pooled estimates of STI test positivity. We narratively synthesized data on secondary outcomes, including adherence to recommended STI screening frequency and changes in STI epidemiology. Of 7477 studies, we included 38 for the meta-analysis and 11 for secondary outcomes. With 2-3 monthly STI screening, the pooled positivity was 0.20 (95% confidence interval [CI]: 0.15-0.25) for chlamydia, 0.17 (95% CI: 0.12-0.22) for gonorrhea, and 0.07 (95% CI: 0.05-0.08) for syphilis. For chlamydia and gonorrhea, the positivity was approximately 50% and 75% lower, respectively, in studies that screened 4-6 monthly vs 2-3 monthly. There was no significant difference in the positivity for syphilis in studies that screened 4-6 monthly compared to 2-3 monthly. Adherence of clients to recommended screening frequency varied significantly (39-94%) depending on population and country. Modeling studies suggest more frequent STI screening could reduce incidence. Although more frequent STI screening could reduce delayed diagnoses and incidence, there remain significant knowledge gaps regarding the optimal STI screening frequency.

Molecular Identification of Cervical Microbes in HIV-Negative and HIV-Positive Women in an African Setting Using a Customized Bacterial Vaginosis Microbial DNA Quantitative PCR (qPCR) Array.

ABSTRACTBacterial vaginosis (BV) is a common polymicrobial vaginal disorder that is associated with sexually transmitted infections (STIs), including HIV. Several studies have utilized broad-range 16S rRNA gene PCR assays with sequence analysis to characterize cervicovaginal bacterial communities of women with healthy and diseased conditions. With the high burden of BV and STIs among African women, there is a need for targeted PCR assays that can rapidly determine the true epidemiological profile of key cervical microbes, including BV-associated bacteria, and a need to explore the utility of such assays for microbiological diagnosis of BV. Here, we used a taxon-directed 16S rRNA gene quantitative PCR (qPCR) assay to examine the prevalences and determinants of specific cervical microbes among African women with and without HIV infection. Cervical samples were collected using a cytobrush from 162 women (aged ≥30 years) attending a community-based clinic in Eastern Cape, South Africa. The samples were screened for specific microbes (i.e., STIs, emerging sexually transmitted pathogens [pathobionts], and BV-associated bacteria) using a customized bacterial vaginosis microbial DNA qPCR array. Statistical analyses were performed using GraphPad Prism v6.01. Chi-square/Fisher’s exact tests were used to evaluate the determinants associated with specific cervical microbes. Only 145 women had any detectable microbes and were included in the analysis. Lactobacillus iners (62.8%) and specific BV-associated bacteria, namely, Gardnerella vaginalis (58.6%), Atopobium vaginae (40.7%), and the pathobiont Ureaplasma parvum (37.9%), were the most prevalent microbes. Hierarchical clustering analysis revealed that 42.8% of the women (62/145) had a diverse array of heterogeneously distributed bacteria typically linked to BV. Women with detectable Lactobacillus species, specifically Lactobacillus crispatus and Lactobacillus jensenii, and to a lesser extent L. iners, had very low prevalence of BV-associated bacteria. Although the cumulative burden of STIs/pathobionts was 62.8%, Chlamydia trachomatis (3.4%), Neisseria gonorrhoeae (4.8%), and Trichomonas vaginalis (4.8%) were detected at low rates. HIV infection was associated with the presence of STIs/pathobionts (P = 0.022) and L. iners (P = 0.003). Prevalent STIs/pathobionts were associated with having multiple partners in the past 12 months (n ≥ 2, P = 0.015), high number of lifetime sexual partners (n ≥ 3, P = 0.007), vaginal sex in the past month (P = 0.010), and decreasing age of women (P = 0.005). C. trachomatis was associated with increasing age among HIV-positive women (P = 0.016). The pathobiont Ureaplasma urealyticum was inversely associated with age of women in the whole cohort (P = 0.018). The overall prevalence of STIs/pathobionts was high and was associated with HIV infection and sexual behavior. Our study helps us to understand the epidemiological trend of STIs and pathobionts and highlights the need to understand the impact of sexual networks on STI and pathobiont transmission and prevention among women in an African setting.IMPORTANCE Bacterial vaginosis (BV), whose etiology remains a matter of controversy, is a common vaginal disorder among reproductive-age women and can increase the risk for sexually transmitted infections (STIs). African women bear a disproportionately high burden of STIs and BV. Using a targeted quantitative PCR (qPCR) assay, a customized bacterial vaginosis microbial DNA qPCR array, we examined the prevalences and determinants of key cervical microbes, including BV-associated bacteria and emerging sexually transmitted pathogens (pathobionts) among women of African descent aged between 30 and 75 years. High-risk behaviors were associated with a higher prevalence of STIs/pathobionts, suggesting the need to better understand the influence of sexual networks on STI and pathobiont transmission and prevention among women. Our molecular assay is important in the surveillance of BV-associated bacteria, pathobionts, and STIs as well as diagnostic microbiology of BV. Furthermore, our research contributes to a better understanding of the epidemiology of STIs and pathobionts in Africa.

Diagnosis and Management of Bacterial Vaginosis: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines.

In preparation for the 2021 Centers for Disease Control and Prevention (CDC) sexually transmitted infections (STIs) treatment guidelines, the CDC convened an advisory group in 2019 to examine recent literature addressing updates in the epidemiology, diagnosis, and management of STIs. This article summarizes recent data in each of these key topic areas as they pertain to bacterial vaginosis (BV), the most common cause of vaginal discharge. The evidence reviewed primarily focused on updates in the global epidemiology of BV, risk factors for BV, data supportive of sexual transmission of BV-associated bacteria, BV molecular diagnostic tests, and novel treatment regimens. Additionally, recent literature on alcohol abstinence in the setting of 5-nitroimidazole use was reviewed.

Awareness and knowledge of sexually transmitted diseases among population in Georgia (epidemiological survey)

Sexually transmitted infections (STIs), often known as sexually transmitteddiseases, are still a major public health concern across the world. According to WHO estimates, sexually transmitted diseases (STIs) have an annual incidence of 357 million cases among which chlamydia (131 million), gonorrhoea (78 million), syphilis (5.6 million) and trichomoniasis (143 million), half of those among young people aged 15—24. Every day, almost one million people worldwide develop an STI, and the majority of them are ignorant of their infection status, making them a source of infection for others. The frequency and consequences of this on the health and socioeconomic condition of whole nations, particularly African countries, have long been regarded as a serious emergency. The epidemiology of STIs, the history and physical findings, screening standards, and the overall approach to combat STIs are all covered in this article. Infections covered in terms of causation, epidemiology, and risk factors include gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and trichomoniasis. For a variety of reasons, the worldwide illness burden represented by STI remains unclear. First, many STIs are asymptomatic; second, diagnostic procedures are unavailable in some of the most affected nations; and finally, surveillance systems are non-existent or very poor in many parts of the world. According to the World Health Organization, there were 340 million new cases of syphilis, gonorrhoea, chlamydia infection, and trichomoniasis in 1999. In the European Union, there has been an increase in the incidence of gonorrhoea and syphilis in recent years. The survey instrument was an online self-administered anonymous questionnaire conducted in Georgia using Google survey software, which automatically populates and saves digital responses to a secure database protecting participant confidentiality throughout the surveying process. The survey was conducted in 2019. The opportunity to participate in the questionnaire was one-time. The question naire for this study was developed based on a review of literature.Health education, early diagnosis and treatment, screening for asymptomatic infections, contact inquiry, and immunization for illnesses for which a vaccine is available should all be used in STI prevention and control. In general, the studies reported low levels of knowledge and awareness of sexually transmitted diseases. Although, as shown by some of the findings on condom use, knowledge does not always translate into behavior change, adolescents’ sex education is important for STD prevention, and the school setting plays an important role.

Bacterial sexually transmitted infections and syndromic approach: a study conducted on women at Moroccan University Hospital.

In Morocco, a syndromic approach has been implemented for sexually transmitted infections (STIs) management. However, those infections can be asymptomatic and the use of the syndromic approach to their management can be inappropriate and lead to dissemination of infection. Therefore, it would be important to determine the epidemiology and risk factors of bacterial STIs (Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG)) in a Moroccan population and their association with symptoms to assess the appropriacy of the use of the syndromic approach. Cervical samples were collected from symptomatic and asymptomatic consenting women attending the University Hospital of Fez and were tested by PCR for NG, CT and MG using specific primers. We assessed the infection status and its association with different risk factors and genital STIs-related symptoms. Of 809 tested for CT, NG and MG, 16.6% tested positive for at least one STI. Of the 134 participants who tested positive for at least one bacterial STI, 74.2% had no genital STIs-related symptoms. Moreover, the results showed a significantly high rate of NG and MG infections in asymptomatic women. However, the determined risk factors for NG, MG and CT infections were menopause (p=0.002), oral contraception (p=0.036) and a high number of parities (p=0.048), respectively. This investigation shows a predominance of NG infection and a high prevalence of STIs in asymptomatic patients. These results highlight that the adopted syndromic approach will not be adapted in the management of these STIs. Thus, the implementation of a systematic diagnostic program in order to enhance their management is needed.

Arthrites et ténosynovites vénériennes

Sexually transmitted infections (STIs) have been on the rise for about twenty years in France and around the world. They are often asymptomatic and yet are responsible for significant genital and systemic morbidity. Although infrequent, the rheumatic manifestations of venereal diseases, in particular arthritis and tenosynovitis, have been known for a long time. They are generally of two types: infectious directly linked to the pathogen (N. gonorrhoeae, syphilis) and more frequently reactive, indirectly linked to the pathogen, which may be necessary for inflammatory rheumatism (C. trachomatis, arthropod-borne viruses, mycoplasmas). Broadly speaking, many other STIs can cause rheumatic manifestations (viral hepatitis, meningococcus). Knowledge of the epidemiology, clinical, diagnostic and therapeutic techniques of STIs is important for rheumatology practice.

How do biases in sex ratio and disease characteristics affect the spread of sexually transmitted infections?

The epidemiology of sexually transmitted infections (STIs) is inherently linked to host mating dynamics. Studies across many taxa show that adult sex ratio, a major determinant of host mating dynamics, is often skewed - sometimes strongly - toward males or females. However, few predictions exist for the effects of skewed sex ratio on STI epidemiology, and none when coupled with sex biased disease characteristics. Here we use mathematical modelling to examine how interactions between sex ratio and disease characteristics affect STI prevalence in males and females. Notably, we find that while overall disease prevalence peaks at equal sex ratios, prevalence per sex peaks at skewed sex ratios. Furthermore, disease characteristics, sex-biased or not, drive predictable differences in male and female STI prevalence as sex ratio varies, with higher transmission and lower virulence generally increasing differences between the sexes for a given sex ratio. Our work reveals new insights into how STI prevalence in males and females depends on a complex interaction between host population sex ratio and disease characteristics.

The role of sexually transmitted infections (STI) prevention and control programs in reducing gender, sexual and STI-related stigma.

The role of sexually transmitted infections (STI) prevention and control programs in reducing gender, sexual and STI-related stigma.

Nonviral sexually transmitted infections in pregnancy: current controversies and new challenges.

This review provides an update of nonviral, curable sexually transmitted infections (STIs) in pregnancy and summarizes our understanding of the current issues and controversies surrounding risk factors, screening, and treatment of STIs in pregnancy primarily in high-income countries (using the United States and the United Kingdom as examples). The infections covered in this review are syphilis, gonorrhea, chlamydia, trichomoniasis, and Mycoplasma genitalium infections. Overall, limited modern data is available to update researchers and clinicians on the epidemiology and care of STIs in pregnancy. Though common risk factors can be identified among these STIs, like socioeconomic status and inadequate antenatal care, specific screening and treatment challenges vary by geography and pathogen. Wherever available, surveillance data and research evidence are often limited to nonpregnant patients, leading to imperfect pregnancy-specific risk estimates and obstetric lags in the development and adoption of new guidelines. We have identified three areas of opportunity that may enhance the effectiveness of current approaches and inform new ones: improved data collection and evidence-based screening practices; prompt and comprehensive therapy, including partner services, and evaluations of new treatment modalities; and equitable antenatal and sexual healthcare for all pregnant persons and their partners. These findings highlight the need to revisit standards of screening and management of STIs in pregnancy in high-income countries.

Epidemiology of sexually transmitted infections among female sex workers in Switzerland: a local, exploratory, cross-sectional study.

Female sex workers are often considered highly vulnerable to sexually transmitted infections (STIs). However, data on STI epidemiology in female sex workers are lacking in Switzerland. Our main goal was to evaluate the prevalence of six STIs (human immunodeficiency virus [HIV], hepatitis B, hepatitis C, Chlamydia trachomatis, Neisseria gonorrhoeae and syphilis) among local female sex workers in Lausanne. A local, exploratory, cross-sectional study was conducted on a convenience sample of adult (≥18 years) Female sex workers in Lausanne, Switzerland, from 1 April 2015 to 31 December 2016. female sex workers who worked in street sex venues, massage parlours and brothels were approached for recruitment by a local non-governmental organisation. They were then invited to present at the Lausanne University Hospital, where they were offered a free STI screening and hepatitis A and B vaccination. We enrolled 96 female sex workers. They were predominantly undocumented immigrants (60%) from Africa and Eastern Europe with no health insurance; only one participant (1%) was Swiss born. During the study, 15 (16%; 95% confidence interval [CI] 9–23%) participants were newly confirmed to have an STI: six (6%; 95% CI 1–11%) had C. trachomatis, five (5%; 95% CI 0.6-9%) latent syphilis and four (4%; 95% CI 0.1–8%) hepatitis B (three with chronic active infection and one with past exposure). No human immunodeficiency virus (HIV) infections were newly diagnosed among the participants. Nineteen (20%) of the female sex workers were already vaccinated against hepatitis B, and 73 (76%) initiated vaccination against hepatitis A and hepatitis B during the study. Forty-four (46%) of the female sex workers required translation and assistance from social services.

Emerging impact of the COVID-19 outbreak on sexual health in Lebanon

Background The coronavirus-2019 (COVID-19) has had compounding effects on the political and economic crisis with severe economic and health consequences. Throughout the lockdown, one of the largest sexually transmitted infections...

Vaginitis and Sexually Transmitted Diseases

Sexually transmitted infections (STIs) are among the most common causes of infectious illness worldwide, and therefore, familiarity with the recognition and management of these infectious pathogens is critical for physicians. This chapter reviews the epidemiology and transmission of STIs and describes the principles of taking a sexual history, reporting STIs, and screening for them. Urethritis, vulvovaginitis, mucopurulent cervicitis, pelvic inflammatory disease (PID), and genital ulcer disease are discussed. STIs in men who have sex with men is discussed, as is anorectal STIs in women. One figure shows a Gram stain in gonorrhea; the other shows ectopic pregnancy and tubal infertility in PID. This review contains 2 figures, 24 tables, and 89 references. Keywords Vulvovaginitis, sexually transmitted infection, herpes, gonorrhea, urethritis, human papilloma virus, syphilis, chlamydia, viral hepatitis, pelvic inflammatory disease

Equine Therapy (ET): Integrating medicine, surgery and psychiatry using a centuries old tool

With more than 374 million new cases of curable sexually transmitted infections (STI) globally each year, STI present a significant disease burden. This article examines the epidemiology of STI, a diverse category of pathogens that are primarily transmitted through sexual contact, and highlights key factors affecting public health and the global burden of STI. The article presents a broad overview of some of the most prevalent persistent viral infections and treatable bacterial infections, with a focus on: human immunodeficiency virus, herpes simplex virus, human papillomavirus, and hepatitis B virus, syphilis, gonorrhea, and chlamydia. The article also offers some general care and management strategies. The article concludes with a discussion about opportunities for sexual health gain and the control of STI and suggests that, ultimately, there remains a pressing need for greater investment in effective STD treatment, diagnosis, prevention, and surveillance.

O33 Significantly higher rates of chlamydia found in army personnel compared with non-military clinic attendees

IntroductionOur Sexual Health service covers a county-wide population, including large numbers of Army personnel. Despite military personnel being recognised as high risk for sexually-transmitted infections (STIs), accurate data on STI...

Profile of sexually transmitted infections among males in a South Indian suburban tertiary care teaching hospital: a one year retrospective study

<p class="abstract"><strong>Background:</strong> The profile of sexually transmitted infections (STIs) is variable due to changes in socio-economic, cultural, geographic & environmental factors in different parts of the country. However, baseline information about the epidemiology of STIs remains essential for designing, implementing and monitoring of successful targeted interventions. The study was conducted with the aim to study the frequency of various STIs among male patients attending the STI outpatient department (OPD) of our hospital during a period of one year<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This is a retrospective study, wherein data collected from January 2016 to December 2016 regarding male attendees to STI clinic in our hospital was used to assess the occurrence of various STIs among male patients during that period.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among the study group (266), most common STI was scabies (33.83%) followed by balanoposthitis (33.08%) and anogenital warts (10.9%). It was also noted that 71% of scabies occurrence was during Jan to April and then December, compared to other months. Early syphilis (Primary/secondary) was detected in 3 subjects. Syphilis occurrence was lower than data from some previous Indian studies<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> There is considerable variation in the incidence of STIs among various regions of our country. There is also a change in occurrence of various STIs over last 2 decades. The reasons could include over-the-counter antibiotic use and more frequent use of antibiotics for other diseases than in the past<span lang="EN-IN">.</span></p>

Causative agents, diseases, epidemiology and diagnosis of sexually transmitted infections

Sexually transmitted infections (STIs) are caused by more than 30 species; the organisms with the highest frequency and clinical importance are Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Mycoplasma genitalium, the hepatitis B and C viruses, the human immunodeficiency virus, the human papillomavirus, the herpes simplex virus type 1 and type 2 and Trichomonas vaginalis. Most of these infections are present without symptoms, and when they are present, the most common clinical manifestations of sexually transmitted diseases include vaginal discharge, genital ulcers and abdominal pain in women. Worldwide more than 1 million people acquire an STI per day, and an estimated 500 million people are infected each year with one of the next four STIs: chlamydia, gonorrhoea, syphilis or trichomoniasis. More than 290 million women are infected with human papillomavirus, and more than 530 million people have the virus that causes herpes simplex virus type 2 at this time. Such infections can have serious consequences beyond the immediate effects of the infection itself, that is transmission from mother to child during pregnancy and childbirth, and chronic diseases. Given the importance of these illnesses, in this review, we present the most important aspects of the causative agents, diseases, epidemiology and diagnosis of STIs.

Rastreio de Infeções Sexualmente Transmissíveis não víricas nos adolescentes: qual o estado da arte

Sexually Transmitted Infections (STI) is a serious public health issue with highest rates among teenagers and young adults. In developed countries, non-viral STI include Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis. Early detection of non-viral STI have a positive impact not only on patients health but also on public health as it allows timely prescription of appropriate treatment, reduces transmission between partners and decreases long-term complications, including pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility. Several international medical societies published recommendations for screening of some non-viral STI in certain groups. In Portugal, the rule of mandatory reporting of communicable diseases was updated by the Direcao Geral de Saude (DGS) in 2014 and includes gonorrhea, syphilis and Chlamydia trachomatis infection. Nevertheless, there are few studies on the epidemiology of STI in Portugal and only just recently the opportunistic screening of genital Chlamydia trachomatis infection was introduced in the National Health Plan 2011-2016. General Practitioner through their holistic person-centered approach of the patients, their family and social context (focusing on personal background / risk behaviors) will necessarily have a decisive role in both the primary prevention and STI screening.