Sexually transmitted infection test-and-treat

Abstract

Globally, the disease burden of sexually transmitted infections (STIs) has remained high over the years. Every day, more than 1 million STIs are acquired around the world. The negative impacts of STIs include morbid sexual and reproductive health, stigmatization, and congenital syphilis. Fortunately, most bacterial STIs (including syphilis, chlamydia, and gonorrhea) are curable, enabling test-and-treat as a useful approach for controlling the epidemics in people at high risk of infection. The 2022–2030 global health sector strategies have set the indicators of >90% screening coverage and >95% of treatment coverage for syphilis and gonorrhoea in priority population. Regular STI testing, usually referring to syphilis, chlamydia, and gonorrhea, in sexually active men who have sex with men (MSM) have been recommended in a few international STI guidelines. With advanced technology development, STI testing spectrum has been expanded, and the testing procedures have been simplified for point-of-care testing or even home-based self-testing. While regular specific STIs testing could be beneficial for key populations, the potential emergence of resistance resulting from selective pressure following intensive screening and treatment of some STI such as gonorrhoea is a concern. The strategy of testing could be the key, which may need to be optimised. New strategy from another approach such as vaccination are under development.