The number of people infected with sexually transmitted infections (STIs) in the United States continues to rise. Not even a global pandemic could disrupt the trend. The fact that cases are becoming increasingly ubiquitous doesn’t mean that’s OK.
The right treatment can cure bacterial STIs such as gonorrhea, syphilis, and chlamydia. And while viral STIs like herpes, HIV, HPV, and hepatitis B are incurable, seeking treatment is still essential.
Prevention is the best way to slow the transmission of all STIs, but it won’t stop them altogether. Here are four advances in STI diagnosis and treatment that might help when prevention is in the rearview mirror.
1. Home Testing, Diagnosis, and Treatment
COVID-19 accelerated the development of telehealth and home testing kits, spawning virtual provider visits and pharmacy options. Long before this, though, some online healthcare providers were already offering easy solutions for sexual health. The ability to take care of everything from home is a game-changer.
Testing is the first step to treating any disease. The easier and more accessible the test, the more likely someone is to take that initial step. And especially for diseases that carry a stigma, at-home STI testing is indispensable.
While some companies offer test kits and results only, many provide testing, diagnosis, and treatment. This allows patients to keep their sensitive medical information personal. They’re able to confirm test results, get prescriptions delivered, and access online providers from the comfort of their homes.
Despite the prevalence of STIs, the stigma attached to them is real. At-home testing eliminates the potential embarrassment of in-person visits, making it more likely for patients to seek treatment for these diseases. This progress may lead to slowing the spread of STIs.
2. Partner Services and Contract Tracing
The pandemic has also made “contact tracing” household terminology. As with any infectious disease, STIs spread like wildfire unless others exposed to them are identified, tested, and treated. The pervasiveness of STIs has given rise to the role of disease intervention specialist (DIS).
Such specialists are on the front lines of public health. They’re charged with doing more than asking someone who tests positive for an STI whom they’ve had sexual contact with. They also inform those who have been exposed and follow up with them regarding testing, treatment, and prevention.
A DIS is equal parts epidemiologist, clinician, detective, counselor, and social services professional. Training is extensive, covering communication, interviewing, field investigation, and plot progression skills. To provide testing and treatment resources, these specialists also must know how and where to refer individuals identified through contact tracing.
Recognizing the need to address the partners of those who test positive for STIs seems like an obvious innovation. But there haven’t always been specialists trained specifically to handle all the complexities of the task. The fact that the DIS is an expanding role is a hopeful development.
3. Races in Research for Cures and Vaccines
At one time, if a person infected with HIV developed AIDS, it was a death sentence. And it was a horrible one at that. The development of HIV medications and treatment regimens now means that few develop AIDS and most live long healthy lives. Research for a cure continues.
Human papillomavirus is the most common STI in the U.S. with around 150 identified strains. If left untreated, some strains of HPV can cause cancer. The HPV vaccine has been available for 16 years, but it has evolved. Once administered only to females, it’s now given to males as well, with dosage guidelines and regimens constantly improving.
Resistance to the antibiotics traditionally used to treat gonorrhea, syphilis, and chlamydia is evolving at an alarming rate. Ceftriaxone is now the only antibiotic effective for treating gonorrhea, usually accompanied by oral azithromycin. With emerging strains of the disease now showing decreased susceptibility to ceftriaxone, there’s a race for new treatments.
So far, medical research has been able to stay one step ahead of the bacterial resistance that’s rendering certain antibiotics useless. The struggle is real, but so are the public and private funding and research necessary to find new solutions. One step ahead is always better than one step behind.
4. Sharper Focus on the Big Picture
Multiple factors may put some people more at risk for acquiring STIs than others. Race, age, gender status, and behaviors are just a few. STIs are not a one-size-fits-all proposition.
Greater time and resources are being focused on not merely looking at the overall numbers of STI cases. Rather, they are investing in identifying trends and the populations that may be at greater risk. For example, racial and ethnic minorities are affected at markedly higher rates than whites. “Risk” itself has been expanded to include not just the likelihood of infection but also barriers to appropriate treatments.
Researchers and public health officials are now breaking down data in new ways in their surveillance of STIs. As a result, prevention, testing, and treatment are being targeted distinctly rather than en masse. Accounting for the pixels that form the big picture is making a positive difference in patient outcomes.
Moving in the Right Direction
The battle against STIs is being fought on multiple fronts. There are stigmas, therapeutic resistance, demographics, and access issues to overcome. But as Frederick Douglass said, “If there is no struggle, there is no progress.”
Amid the challenges, progress is being made in the fight to improve sexual health. Since STIs are unlikely to be eradicated, progress is the best weapon in our arsenal.
