Sexually transmitted disease

STIs increasing worldwide, study finds

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The absolute incidence and disability-adjusted life-years for STIs increased globally over 2 decades, especially in sub-Saharan Africa and Latin America, according to a recently published study.

“Sexually transmitted infections are a major public health issue worldwide, but there is a paucity of literature on their burden and trends globally,” researchers wrote in The Lancet Infectious Diseases. “We aimed to assess the global disease burden and trends of STIs from 1990 to 2019.”

Source: CDC.gov
Globally, sexually transmitted infections continue to be a public health challenge, even more so in sub-Saharan Africa and Latin America.

They conducted an observational trend study, collecting data on incident cases, age-standardized incidence rate, and disability-adjusted life-years (DALYs), and calculated age-standardized DALY rates, for syphilis, chlamydia, gonorrhea, trichomonas and genital herpes between 1990 and 2019. Using the Global Burden of Disease study 2019, they assessed the data by sex, geographical region and cause.

Overall, the study showed that globally, the age-standardized incidence rate of STIs indicated a decreasing trend, with an estimated annual percentage change of 0.04 (95% UI, 0.08 to 0) from 1990 to 2019, reaching 9,535.71 cases per 100,000 person-years in 2019.

According to the researchers, sub-Saharan Africa had the highest age-standardized incidence rate (19,973.12 per 100,000 person-years) and age-standardized DALY rate (389.32 per 100,000 person-years). The highest incidence rate overall was among adolescents (18,377.82 per 100,000 person-years). Men had a higher age-standardized incidence rate (10,471.63 per 100,000 person-years) compared with women (8,602.4 per 100,000 person-years), although women had a higher age-standardized DALY rate (33.31 per 100,000 person-years) than men (12.11 per 100,000 person-years).

“Although most countries showed a decrease in age-standardized rates of incidence and DALYs for STIs, the absolute incident cases and DALYs increased from 1990 to 2019,” the authors wrote. “Therefore, STIs still represent a global public health challenge, especially in sub-Saharan Africa and Latin America, which warrants more attention and health prevention service.”

The United States has also seen a sustained increase in STIs.

CDC Issues Guidance on Pre-Exposure Prophylaxis for HIV in Heterosexual Adults.

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The CDC has released interim recommendations on providing pre-exposure prophylaxis (PrEP) to prevent HIV in very-high-risk heterosexual adults — for example, those whose partners are infected.

Among the recommendations, published in MMWR:

  • Before prescribing PrEP, clinicians should screen patients for sexually transmitted infections and hepatitis B.
  • Clinicians should explain to women that the effect of the drugs on the developing fetus is not fully known, but no harms have been reported so far. Breast-feeding mothers should not receive PrEP.
  • When pregnant women take PrEP, clinicians can anonymously submit data on the pregnancy to the Antiretroviral Pregnancy Registry.
  • Tenofovir disoproxil fumarate (TDF) 300 mg plus emtricitabine (FTC) 200 mg (i.e., one Truvada tablet) should be taken daily, and patients should be given no more than a 90-day supply.
  • HIV tests should be administered every 2 to 3 months.
  • Women should take a pregnancy test at each follow-up visit.

Source: MMWR