Challenges and Solutions to STI Control in the Era of HIV and STI Prophylaxis.
Felix Ong'era MogakaJenell StewartVictor OmolloElizabeth BukusiPublished in: Current HIV/AIDS reports (2023)
The incidence of STIs continues to rise globally especially among HIV PrEP users, with an estimated 1 in 4 PrEP users having a curable bacterial STI. STIs and HIV comprise a syndemic needing dual interventions. The majority of STIs are asymptomatic, and when testing is available, many STIs occur in extragenital sites that are missed when relying on urine testing or genital swabs. Optimal testing and treatment, including testing for antimicrobial resistance, pose difficulties in high income countries and is essentially non-existent in most low- and middle-income countries. Novel STI primary prevention strategies, like doxycycline post-exposure prophylaxis (PEP) for STI prevention, have proven to be highly efficacious in some populations. A few jurisdictions have issued normative guidelines and position statements for doxycycline PEP; however, clinical standards for implementation and data on public health impact are limited. STI incidence rates are high and rising in sexually active populations. Sexual health programs should leverage the expansion of HIV PrEP delivery services to integrate STI testing, surveillance, and novel STI prevention services.
Keyphrases
- men who have sex with men
- hiv testing
- hiv positive
- public health
- antimicrobial resistance
- healthcare
- primary care
- mental health
- antiretroviral therapy
- risk factors
- physical activity
- hiv infected
- human immunodeficiency virus
- hiv aids
- machine learning
- smoking cessation
- health insurance
- global health
- replacement therapy