Report From the National Academies of Sciences, Engineering and Medicine—STI: Adopting a Sexual Health Paradigm—A Synopsis for Sexually Transmitted Infection Practitioners, Clinicians, and Researchers

Abstract

Despite decades of medical, diagnostic, and public health advances related to diagnosis and management of sexually transmitted infections (STIs), rates of reportable STIs continue to grow. A 2021 National Academies of Sciences, Engineering, and Medicine report on the current state of STI management and prevention in the United States, entitled Sexually Transmitted Infections: Adopting a Sexual Health Paradigm, offers recommendations on future public health programs, policy, and research. This new report builds upon the 1997 Institute of Medicine report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases, and provides 11 recommendations organized under 4 action areas: (1) adopt a sexual health paradigm, (2) broaden ownership and accountability for responding to STIs, (3) bolster existing systems and programs for responding to STIs, and (4) embrace innovation and policy change to improve sexual health. We present our interpretive synopsis of this report, highlighting elements of particular interest to STI and sexual health practitioners, including clinicians, researchers, disease intervention specialists, community outreach workers, and public health staff. The report asserts that it is possible to create a healthier and more equitable future where fewer adolescents and adults are infected, fewer babies are born with STIs, and people entering their sexual debut and continuing throughout the life span are taught the language and skills to conceptualize and enact their own vision for what it means to be sexually healthy.

Testing Technologies as Enhancers of Disease Intervention Specialist Activities: Applying Lessons From COVID-19

“…Traditional sexually transmitted infection (STI) control programs are predominately opportunistic in nature relying on (1) people recognizing symptoms, or being aware of infection risk, and seeking care and/or (2) primary care providers offering recommended screening (e.g., chlamydia screening for young women, screening of men on HIV preexposure prophylaxis [PrEP], or screening of pregnant women, etc.). 1 This passive approach has had limited success, as evidenced by continually climbing case rates, 2 for a number of reasons including, but not limited to, barriers to access to STI-specific health care 3,4 and hesitancy on the part of primary care providers 5 to perform routine screening as evidenced by low adherence to practice recommendations for chlamydia screening. 6 Newer diagnostic technologies may provide additional options in our screening and diagnostic toolbox.…”

“… 1 . This passive approach has had limited success, as evidenced by continually climbing case rates, 2 for a number of reasons including, but not limited to, barriers to access to STI-specific health care 3,4 and hesitancy on the part of primary care providers 5 to perform routine screening as evidenced by low adherence to practice recommendations for chlamydia screening 6 …”

Summary of the Fourth Annual American Sexually Transmitted Diseases Association Workshop on Improving Sexually Transmitted Infection Control Efforts Through Cross-Sector Collaboration

“…Point-of-care tests allow for immediate, accurate treatment, decreasing the risk of loss to follow-up and potentially reducing transmission rates and prevalence of STIs. [5][6][7] Despite known benefits and regulatory approval, challenges exist with POC testing for STIs. Development of POC tests requires consideration of implementation into clinical practice.…”

“…Both the STI National Strategic Plan (2021–2025) 3 and the 2021 National Academies of Sciences, Engineering, and Medicine report 4 identify molecular POC tests as innovative tools and recommend their implementation to improve STI care. Point-of-care tests allow for immediate, accurate treatment, decreasing the risk of loss to follow-up and potentially reducing transmission rates and prevalence of STIs 5–7 …”

Prioritizing syphilis control: Now is the time for action

“…Incomplete partner services before COVID-19 have thwarted syphilis control programs. Syphilis partner services are chronically under-funded within many public health departments ( 16 ), contributing to incomplete partner service programs for early syphilis cases ( 17 ).…”