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Innovation

Sexually transmitted infections (STIs)

Safeguarding sexual wellness

Sex is an important part of the human experience and has been linked to an improved quality of life.1

There are more than 1 million sexually transmitted infections (STIs) acquired every day worldwide,2 and diagnostic testing is often the first line of defense. The impact of quality diagnostics and innovative testing approaches has transformed previously life-altering infections into manageable conditions.3

 

concerned looking woman
Taking a lesson from human immunodeficiency virus (HIV)

For decades, HIV/AIDS routinely ranked in the top 10 global causes of death.4 Today, testing and treatment have greatly reduced the impact and prevalence of the disease in developed countries. However, there has been a noticeable uptake in infection rates among younger populations. This is believed to stem in part from lack of knowledge and a lack of compliance when relying on medication used to prevent the spread of disease, such as pre-exposure prophylaxis (PrEP).

In low- and middle-income countries, HIV/AIDS remains a persistent public health threat which is being addressed with increased access to effective HIV prevention, diagnosis, treatment and care. No matter where people live, an early HIV diagnosis is key to living a long and healthy life.

Other notable STIs and their socioeconomic impact

376_million

In 2016, the WHO estimated 376 million new infections with 1 of 4 STIs: chlamydia (127 million), gonorrhea (87 million), syphilis (6.3 million) and trichomoniasis (156 million).2

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High-risk human papillomavirus (HPV) infection is linked to >99% of all cervical cancer cases—the fourth most common cancer in women globally.6

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Genital herpes (herpes simplex virus type 2 [HSV-2]) is estimated to affect 491.5 million people, approximately 13% of the world’s population.7

Global preventative approaches to address the immediate challenges of STI risks include education and access to reliable screening and diagnostic tests, as more than 90% of the global burden of STIs occur in low- to middle-income countries.8 Conversely, higher income countries face another troubling trend in the form of drug-resistant infections.

Regardless of geography or financial standing, laboratories play a vital role in supporting people’s physical (and mental) wellbeing. Advances in diagnostic testing have opened new possibilities across a wide range of infections, and understanding the available options is vital to meeting the needs of local communities. 

male and female healthcare
Meeting demand with diagnostic innovation

For some infections, reliably identifying the cause poses a notable challenge. High-throughput systems and fully automated workflows are helping to accelerate time-to-diagnosis, but this is just part of the equation. 

Optimising nucleic acid amplification testing (NAAT) techniques, like polymerase chain reaction (PCR) testing, have allowed test developers to push the boundaries of traditional diagnostics. Increasingly sophisticated assays with better sensitivity, specificity, and efficiency of scale have the potential to bring an entire paradigm shift in disease management, as seen in HPV screening for cervical cancer prevention.

Simultaneous testing for multiple targets is one approach to enhance the reliability of testing. Compensating for the possibility of genotype variations, mutations and mismatches has increased the probability of detection for infections like HIV, syphilis, hepatitis C virus (HCV), and chlamydia, and can help to preemptively identify cases of co-infection. Similarly, advances in testing strategies—like running multiple tests on a single patient sample in the same run—helps to decrease the burden on laboratory staff. By improving the use of precious personnel resources, laboratories can flexibly meet surges in demand while maximising the value they provide across the health system.

For markets where populations are spread throughout sprawling remote areas, new ways of collecting samples and communicating results have revolutionised disease management—from initial diagnosis, to monitoring viral load, and promoting patient follow-up.

An established legacy of well-designed, high-quality assays

Tests developed according to rigorous performance standards have the potential to address key customer needs while maximising clinical utility.

  • Setting a new standard in cervical cancer screening
  • Ensuring HIV diagnostic tools are updated as the virus mutates
  • Expanding assay menus across platforms to support high volume screening programs                 
Looking ahead, new and familiar challenges are reinforcing the importance of holistic laboratory solutions
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Directly targeting antimicrobial resistance

An increasing number of STIs have developed drug-resistant strains that are complicating patient management. Roche is countering this with a collection of resistance-guided therapy tests that may help bring these infections back under control.

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Ensuring access for all to high quality diagnostics

The Global Access Program, in partnership with other global healthcare leaders, is working to ensure people everywhere have access to innovative testing solutions for the world’s most burdensome diseases—HIV, HCV, HPV, HBV, and Tuberculosis.

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Bringing healthcare thinking to technology

Roche’s purpose-built digital solutions can uncover actionable insights that inform meaningful clinical decisions for patients facing the most serious challenges.

Increased education and awareness, together with the right diagnostic tools, can help us move closer to a world of improved sexual health and wellness. Working together, we can mitigate the impact of sexually transmitted infections to protect global populations of today and future generations tomorrow. 

References

  1. Flynn KE, Lin L, Bruner DW, et al. Sexual Satisfaction and the Importance of Sexual Health to Quality of Life Throughout the Life Course of U.S. Adults. J Sex Med. 2016;13(11):1642-1650. doi:10.1016/j.jsxm.2016.08.011
  2. World Health Organization. Sexually transmitted infections (STIs). https://www.who.int/news-room/detail/06-06-2019-more-than-1-million-new-curable-sexually-transmitted-infections-every-day. Accessed September 8, 2020.
  3. World Health Organization. HIV: from a devastating epidemic to a manageable chronic disease. https://www.who.int/publications/10-year-review/hiv/en/. Accessed September 8, 2020.
  4.  World Health Organization. The top 10 causes of death. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. Accessed September 8, 2020.
  5. Bekker LG, Hosek S. HIV and adolescents: focus on young key populations. J Int AIDS Soc. 2015;18(2Suppl 1):20076. Published 2015 Feb 26. doi:10.7448/IAS.18.2.20076
  6. World Health Organization. Cervical cancer. https://www.who.int/health-topics/cervical-cancer#tab=tab_1. Accessed September 8, 2020.
  7. World Health Organization. Massive proportion of world’s population are living with herpes infection. https://www.who.int/news-room/detail/01-05-2020-massive-proportion-world-population-living-with-herpes-infection. Accessed September 8, 2020.
  8. World Health Organization. Point-Of-Care Diagnostic Tests (POCTs) for Sexually Transmitted Infections (STIs). https://www.who.int/reproductivehealth/topics/rtis/pocts/en/. Accessed September 8, 2020.
  9. Wright TC Jr, Stoler MH, Sharma A, et al. Evaluation of HPV-16 and HPV-18 genotyping for the triage of women with high-risk HPV+ cytology-negative results. Am J Clin Pathol. 2011;136(4):578-586. doi:10.1309/AJCPTUS5EXAS6DKZ