Article

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

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 a lack of knowledge and a lack of compliance when relying on medications 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 2020, The WHO estimated 374 million new infections with 1 of 4 STIs: chlamydia (129 million), gonorrhoea (82 million), syphilis (7.1 million) and trichomoniasis (156 million).2

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Eight pathogens are linked to the greatest incidence of STIs. Of these, 4 are currently curable: syphilis, gonorrhoea, chlamydia and trichomoniasis. The other 4 are incurable viral infections: hepatitis B, herpes simplex virus (HSV), HIV and human papillomavirus (HPV).

In addition, emerging outbreaks of new infections that can be acquired by sexual contact such as monkeypox, Shigella sonnei, Neisseria meningitidis, Ebola and Zika, as well as re-emergence of neglected STIs such as lymphogranuloma venereum.6

491_million

An estimated 491.5 million people were living with HSV-2 infection in 2016, equivalent to 13.2% of the world’s population aged 15 to 49 years. HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital herpes).

An estimated 3.7 billion people had HSV-1 infection during the same year – around 66.6% of the world’s population aged 0 to 49.

People infected with HSV have a higher risk of being infected with HIV.7

 

Together we can mitigate the impact of sexually transmitted infections to protect global populations of today and tomorrow by increasing awareness, education and right diagnostic tools and proper treatment schemes.

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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.

Optimizing nucleic acid amplification testing (NAAT) techniques, like polymerase chain reaction (PCR) testing, has 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 prevention9

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 maximizing 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 revolutionized disease management—from initial diagnosis, to monitoring viral load, and promoting patient follow-up.

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 drugresistant 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.

Antimicrobial resistance products

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 August 2023.
  3. Ten years in public health, 2007–2017: report by Dr Margaret Chan, Director-General, World Health Organization. Geneva: World Health Organization; 2017. https://www.who.int/publications/i/item/ten-years-in-public-health-2007-2017. Accessed August 2023.
  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 August 2023.
  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 https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis) 
  7. World Health Organization: https://www.who.int/news-room/detail/01-05-2020-massive-proportion-world-population-living-with-herpes-infection
  8. Global strategy for the prevention and control of sexually transmitted infections: 2006 - 2015: breaking the chain of transmission. https://apps.who.int/iris/handle/10665/43853. Accessed August 2023.
  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