Global, regional, and national burden of HIV and other sexually transmitted infections among women of childbearing age from 1990 to 2021.

Abstract

Sexually transmitted infections (STIs) represent a significant public health burden, particularly among women of childbearing age. This study aims to analyze the global, regional, and national age-standardized rates of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for STIs among women aged 15-49 from 1990 to 2021. Data were sourced from the Global Burden of Disease 2021 database, and age-standardized rates were calculated using direct standardization methods. Temporal trends were evaluated through average annual percentage change (AAPC) via jointpoint regression analysis. In 2021, compared with other STIs, HIV/AIDS had the highest age-standardized mortality rate (12.98 per 100,000; 95% CI: 10.04 to 16.84) and DALY rate (829.89; 95% CI: 658.73 to 1,056.91). Trichomoniasis had the highest incidence (6,709.73; 95% CI: 3,676.25 to 10,839.25), and genital herpes had the highest prevalence (17,137.09; 95% CI: 13,485.32-21,121.75). From 1990 to 2021, trichomoniasis showed the sharpest increase in incidence (AAPC: 0.27 [95% CI: 0.25 to 0.30]), while HIV/AIDS had the greatest rise in prevalence (AAPC: 3.50 [3.35 to 3.65]), mortality (AAPC: 1.49 [0.97 to 2.02]), and DALYs (AAPC: 1.52 [1.02 to 2.01]). In contrast, gonococcal infection exhibited the steepest declines in prevalence (AAPC: -0.46 [-0.49 to -0.43]) and mortality (AAPC: -1.16 [-1.34 to -0.97]), while syphilis had the largest decrease in DALYs (AAPC: -1.14 [-1.32 to -0.96]). Regional and national disparities were evident across all metrics. These findings highlight the ongoing and uneven burden of STIs and the need for tailored screening and prevention strategies.

Importance: Sexually transmitted infections (STIs) pose a significant public health challenge, particularly among women of childbearing age, with substantial impacts on individual health and societal wellbeing. This study provides a comprehensive analysis of the global, regional, and national age-standardized rates of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for STIs among women aged 15-49 over the past three decades. The findings reveal alarming trends, with HIV/AIDS topping the list in terms of mortality and DALYs and trichomoniasis and genital herpes showing high incidence and prevalence rates. These data highlight the urgent need for targeted screening and preventive interventions to address the disparities in STI burden across regions and countries. By understanding the trends and patterns of STIs, policymakers and healthcare providers can develop effective strategies to reduce the transmission and impact of these infections among women of reproductive age, thereby improving global public health outcomes.