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Elendu C, Amaechi DC, Elendu ID, Elendu TC, Amaechi EC, Usoro EU, Chima-Ogbuiyi NL, Arrey Agbor DB, Onwuegbule CJ, Afolayan EF, Balogun BB. Global perspectives on the burden of sexually transmitted diseases: A narrative review. Medicine (Baltimore) 2024; 103:e38199. [PMID: 38758874 PMCID: PMC11098264 DOI: 10.1097/md.0000000000038199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/19/2024] [Indexed: 05/19/2024] Open
Abstract
Sexually transmitted diseases (STDs) pose a significant global health challenge with far-reaching social, economic, and public health implications. These infections have haunted humanity from ancient times to today, transcending geographical boundaries and cultural contexts. This article explores the multifaceted landscape of STDs, delving into their epidemiology, pathophysiology, clinical manifestations, and global response strategies. The global prevalence of STDs is staggering, with millions of new cases reported annually. Prominent among these infections is HIV/AIDS, which remains a major global health crisis, affecting over 38 million people worldwide. Additionally, bacterial STDs like chlamydia, gonorrhea, and syphilis continue to pose significant health risks, with millions of new cases reported yearly. Beyond the physical manifestations, STDs have profound social and economic implications. They can result in severe reproductive health issues, stigma, discrimination, and psychological distress, burdening healthcare systems and affecting individuals' quality of life. The global response to STDs has been multifaceted, with international organizations and governments implementing various prevention and control strategies, including sexual education programs and scaling up access to testing and treatment. However, challenges persist, including disparities in healthcare access, sociocultural factors influencing transmission, and evolving pathogens with increasing resistance to treatment. Through case studies and real-world examples, we illuminate the human stories behind the statistics, highlighting the lived experiences of individuals grappling with STDs and the complex interplay of factors shaping their journeys. Ultimately, this review calls for continued research, innovative strategies, and sustained global commitment to mitigating the burden of STDs and promoting sexual health and well-being for all.
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Chow EPF, Fairley CK. The role of saliva in gonorrhoea and chlamydia transmission to extragenital sites among men who have sex with men: new insights into transmission. J Int AIDS Soc 2019; 22 Suppl 6:e25354. [PMID: 31468730 PMCID: PMC6715946 DOI: 10.1002/jia2.25354] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 06/26/2019] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Gonorrhoea and chlamydia cases have been rising among gay, bisexual and other men who have sex with men (MSM) over the last decade. The majority of cases are extragenital and occur at the oropharynx and anorectum. The aim of this narrative review was to review the risk factors and mode of transmission for gonorrhoea and chlamydia at the oropharynx and anorectum among MSM. RESULTS AND DISCUSSION New evidence suggests that oropharyngeal gonorrhoea can be transmitted by kissing in addition to through the established route of condomless oral sex; and anorectal gonorrhoea can be acquired when saliva is used as a lubricant for anal sex and rimming in addition to the established route of condomless penile-anal sex in MSM. In contrast, condomless penile-anal sex remains the major route for chlamydia transmission. CONCLUSIONS Substantial transmission of gonorrhoea may occur with practices other than the established routes of condomless oral and/or anal sex and hence condoms may not be effective in preventing gonorrhoea transmission to extragenital sites. In contrast, condoms are effective for chlamydia control because it is mainly transmitted through condomless penile-anal sex. Novel interventions for gonorrhoea that reduce the risk of transmission at extragenital site are required.
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Affiliation(s)
- Eric PF Chow
- Melbourne Sexual Health CentreAlfred HealthCarltonVICAustralia
- Central Clinical SchoolMonash UniversityMelbourneVICAustralia
| | - Christopher K Fairley
- Melbourne Sexual Health CentreAlfred HealthCarltonVICAustralia
- Central Clinical SchoolMonash UniversityMelbourneVICAustralia
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Downs JS, Ashcraft AM, Murray PJ, Berlan ED, Bruine de Bruin W, Eichner J, Fischhoff B, Leary JM, McCall RB, Miller E, Salaway J, Smith-Jones J, Sucato GS. Video Intervention to Increase Perceived Self-Efficacy for Condom Use in a Randomized Controlled Trial of Female Adolescents. J Pediatr Adolesc Gynecol 2018; 31:291-298.e2. [PMID: 29126824 PMCID: PMC5938151 DOI: 10.1016/j.jpag.2017.10.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/24/2017] [Accepted: 10/28/2017] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVE To assess the effects of the Seventeen Days interactive video on young women's perceived self-efficacy for using condoms 6 months after being offered the intervention, relative to a control. DESIGN Multisite randomized controlled trial. SETTING Twenty participating health clinics and county health departments in Ohio, Pennsylvania, and West Virginia. PARTICIPANTS Sexually active female adolescents ages 14 to 19 years. INTERVENTIONS Seventeen Days (treatment intervention; sex education) vs Driving Skills for Life (control intervention; driving education). MAIN OUTCOME MEASURES Perceived self-efficacy for condom use. RESULTS Participants in the Seventeen Days group reported higher perceived condom acquisition self-efficacy after 6 months than those in the driving group. This finding held after controlling for baseline self-efficacy scores and other covariates. CONCLUSION The Seventeen Days program shows promise to improve perceived self-efficacy to acquire condoms among sexually active female adolescents-an important precursor to behavior change.
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Affiliation(s)
- Julie S Downs
- Carnegie Mellon University, Department of Social and Decision Sciences, Pittsburgh, Pennsylvania.
| | - Amie M Ashcraft
- West Virginia University, Department of Pediatrics, Morgantown, West Virginia
| | - Pamela J Murray
- West Virginia University, Department of Pediatrics, Morgantown, West Virginia
| | - Elise D Berlan
- Ohio State University College of Medicine, Adolescent Medicine, Columbus, Ohio
| | | | - Joan Eichner
- University of Pittsburgh, Office of Child Development, Pittsburgh, Pennsylvania
| | - Baruch Fischhoff
- Carnegie Mellon University, Department of Social and Decision Sciences, Pittsburgh, Pennsylvania
| | - Janie M Leary
- Fairmont State University School of Education, Health, and Human Performance, Fairmont, West Virginia
| | - Robert B McCall
- University of Pittsburgh, Office of Child Development, Pittsburgh, Pennsylvania
| | - Elizabeth Miller
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jennifer Salaway
- University of Pittsburgh, Office of Child Development, Pittsburgh, Pennsylvania
| | - Janell Smith-Jones
- University of Pittsburgh, Office of Child Development, Pittsburgh, Pennsylvania
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Downs JS, Bruine de Bruin W, Fischhoff B, Murray PJ. Behavioral Decision Research Intervention Reduces Risky Sexual Behavior. Curr HIV Res 2015; 13:439-46. [PMID: 26149165 PMCID: PMC5523954 DOI: 10.2174/1570162x13666150511145328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 05/08/2014] [Accepted: 01/06/2014] [Indexed: 11/22/2022]
Abstract
Although adolescents are at disproportionate risk for sexually transmitted infections, most sex education programs have shown little effect on sexual behavior. An interactive video intervention developed by our team has been identified as one of a few programs that have been documented to reduce sexually transmitted infections in this population. Building on behavioral decision research, we used a mental models approach to interview young women about their sexual decisions, finding, among other things, the strong role of perceived social norms. We based our intervention on these results, aiming to help young women identify and implement personally and socially acceptable decision strategies. A randomized controlled trial found that the video reduced risky sexual behavior and the acquisition of chlamydia infection. We recently revised the video to suit more diverse audiences, and upgraded it to modern standards of cinematography and interactivity. It is now in field trial.
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Affiliation(s)
- Julie S Downs
- Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, PA 15213- 3890, USA.
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Structural approaches for prevention of sexually transmitted HIV in general populations: definitions and an operational approach. J Int AIDS Soc 2014; 17:19052. [PMID: 25204872 PMCID: PMC4159948 DOI: 10.7448/ias.17.1.19052] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 07/17/2014] [Accepted: 08/07/2014] [Indexed: 01/06/2023] Open
Abstract
Introduction Although biomedical HIV prevention efforts have seen a number of recent promising developments, behavioural interventions have often been described as failing. However, clear lessons have been identified from past efforts, including the need to address influential social, economic and legal structures; to tailor efforts to local contexts; and to address multiple influencing factors in combination. Despite these insights, there remains a pervasive strategy to try to achieve sexual behaviour change through single, decontextualized, interventions or sets of activities. With current calls for structural approaches to HIV as part of combination HIV prevention, though, there is a unique opportunity to define a structural approach to HIV prevention as one which moves beyond these past limitations and better incorporates our knowledge of the social world and the lessons from past efforts. Discussion A range of interlinked concepts require delineation and definition within the broad concept of a structural approach to HIV. This includes distinguishing between “structural factors,” which can be seen as any number of elements (other than knowledge) which influence risk and vulnerability, and “structural drivers,” which should be reserved for situations where an empirically established relationship to a target group is known. Operationalizing structural approaches similarly can take different paths, either working to alter structural drivers or alternatively working to build individual and community resilience to infection. A “structural diagnostic approach” is further defined as the process one undertakes to develop structural intervention strategies tailored to target groups. Conclusions For three decades, the HIV prevention community has struggled to reduce the spread of HIV through sexual risk behaviours with limited success, but equally with limited engagement with the lessons that have been learned about the social realities shaping patterns of sexual practices. Future HIV prevention efforts must address the multiple factors influencing risk and vulnerability, and they must do so in ways tailored to particular settings. Clarity on the concepts, terminology and approaches that can allow structural HIV prevention efforts to achieve this is therefore essential to improve the (social) science of HIV prevention.
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Gottlieb SL, Low N, Newman LM, Bolan G, Kamb M, Broutet N. Toward global prevention of sexually transmitted infections (STIs): the need for STI vaccines. Vaccine 2014; 32:1527-35. [PMID: 24581979 PMCID: PMC6794147 DOI: 10.1016/j.vaccine.2013.07.087] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 07/23/2013] [Indexed: 02/06/2023]
Abstract
An estimated 499 million curable sexually transmitted infections (STIs; gonorrhea, chlamydia, syphilis, and trichomoniasis) occurred globally in 2008. In addition, well over 500 million people are estimated to have a viral STI such as herpes simplex virus type 2 (HSV-2) or human papillomavirus (HPV) at any point in time. STIs result in a large global burden of sexual, reproductive, and maternal-child health consequences, including genital symptoms, pregnancy complications, cancer, infertility, and enhanced HIV transmission, as well as important psychosocial consequences and financial costs. STI control strategies based primarily on behavioral primary prevention and STI case management have had clear successes, but gains have not been universal. Current STI control is hampered or threatened by several behavioral, biological, and implementation challenges, including a large proportion of asymptomatic infections, lack of feasible diagnostic tests globally, antimicrobial resistance, repeat infections, and barriers to intervention access, availability, and scale-up. Vaccines against HPV and hepatitis B virus offer a new paradigm for STI control. Challenges to existing STI prevention efforts provide important reasons for working toward additional STI vaccines. We summarize the global epidemiology of STIs and STI-associated complications, examine challenges to existing STI prevention efforts, and discuss the need for new STI vaccines for future prevention efforts.
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Affiliation(s)
- Sami L Gottlieb
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
| | - Nicola Low
- Department of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Lori M Newman
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Gail Bolan
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary Kamb
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nathalie Broutet
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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