Sexually Transmitted Infections

The WHO global health sector strategy on sexually transmitted infections, 2016–2021, endorsed by the World Health Assembly in 2016, aims to eliminate STIs as a public health threat by 2030. In 2019, WHO published estimates of new cases of chlamydia, gonorrhoea, syphilis and trichomoniasis. Recent changes in the epidemiology of STIs and progress in prevention, diagnosis and treatment of STIs and HIV have necessitated changes in approaches to STI prevention and management. To address these STIs, the most widely used approach in clinical settings is the syndromic management of STIs. In most resource-limited settings, the syndromic management flow charts are still the standard of care where laboratory diagnosis is not available or is hard to access. The objectives of these guidelines are to provide updated, evidence-informed clinical and practical recommendations on the case management of people with symptoms of STIs; and to support countries in updating their national guidelines for the case management of people with symptoms of STIs. These guidelines include the management of symptomatic infections related to urethral discharge syndrome, including persistent urethral discharge syndrome; vaginal discharge syndrome, including persistent vaginal discharge; anorectal infection; genital ulcer disease syndrome; and lower abdominal pain syndrome. These guidelines are intended for programme managers for STI prevention and control at the national level and the health-care providers at the frontline – primary, secondary and tertiary health care.

This comprehensive, well-illustrated, and easily accessible book documents the latest research outcomes concerning sexually transmitted infections (STIs) and describes important advances in their prevention, diagnosis and treatment. The changes in the epidemiology and clinical aspects of STIs that have occurred over the past decade are fully explored, with special attention to core groups and patients with immunological disorders. The emerging challenges associated with particular sexually transmitted pathogens, including C. trachomatis, N. gonorrhoeae, HPV, and HIV, are identified and discussed. Readers will find detailed information on modern preventive strategies, new laboratory and diagnostic techniques, and a range of innovative treatments, including vaccines, continuous antiretroviral therapy, and new drugs against hepatitis viruses. Attention is also drawn to new directions in biomedical research that promise clinical benefits for the patients and communities. The combination of a detailed clinical and research approach, with emphasis on new knowledge and innovative aspects, ensures that the book will be of value to a wide readership comprising both clinicians and researchers.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

This book is designed to present a comprehensive and state-of the-art update that covers the pathophysiology, epidemiology, and clinical presentation of the most frequently encountered STIs in adolescence and young adulthood. The introductory sections discuss more general themes including approaches to obtaining a sexual history and exam, concerns of sexual minority youth, ethical and legal considerations, and health disparities in STIs in this population. Subsequent chapters are organized by pathogen such as herpes simplex virus, and human immunodeficiency virus, or clinical syndrome including pelvic inflammatory disease, and vaginitis. Each chapter begins with a case study to illustrate key characteristics of the disease process in question and includes rich illustrations, resources, and guidelines. Written by experts in the field, the text includes a review of epidemiology, pathophysiology, treatment, prevention, and adolescent-specific considerations that is vital to working with this important population. With its transdisciplinary perspective, Sexually Transmitted Infections in Adolescence and Young Adulthood is a unique text that is valuable to infectious disease specialists, adolescent medicine specialists, gynecologists, primary care physicians, advanced practice providers, medical administrative staff, school nurses, sexual health educators, social workers, and public health officials.

The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexualityâ€"the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.

This comprehensive, up-to-date reference book is intended to serve as the standard guide in the field. It covers the epidemiology and etiology of the various sexually transmitted infections and associated diseases, reviews novel diagnostic methods, and discusses in depth both new and established treatment methods. An important part of the book is devoted to prevention and particularly to immunoprevention by vaccination. Related issues such as sexual abuse, psychosocial aspects, and economic and political considerations are also included. The expertise of many worldwide renowned specialists and superb color illustrations make this book a valuable resource for practitioners from a variety of medical disciplines. It has a reader-friendly structure with “core messages” and “take-home pearls”.

One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.