Diagnosis of Sexually Transmitted Infections (STIs)
Accurate diagnostic tests for STIs are widely used in high-income countries. These are especially useful for the diagnosis of asymptomatic infections. However, in low- and middle-income countries, diagnostic tests are largely unavailable. Where testing is available, it is often expensive and geographically inaccessible; and patients often need to wait a long time (or need to return) to receive results. As a result, follow up can be impeded and care or treatment can be incomplete.
- The only inexpensive, rapid tests currently available for STIs are for syphilis and HIV
- The rapid syphilis test is already in use in some resource-limited settings
- A rapid dual HIV/syphilis test is not available whereby a person can be tested for HIV and syphilis from a single finger-stick and using a single testing cartridge
- These tests are accurate, can provide results in 15 to 20 minutes, and are easy to use with minimal training
- Rapid syphilis tests have been shown to increase the number of pregnant women tested for syphilis
- However, increased efforts are still needed in most low- and middle-income countries to ensure that all pregnant women receive a syphilis test
Treatment of STIs
Effective treatment is currently available for several STIs:
- Three bacterial STIs (chlamydia, gonorrhoea and syphilis) and one parasitic STI (trichomoniasis) are generally curable with existing, effective single-dose regimens of antibiotics
- For herpes and HIV, the most effective medications available are antivirals that can modulate the course of the disease, though they cannot cure the disease
- For hepatitis B, antiviral medications can help to fight the virus and slow damage to the liver
- Antimicrobial resistance (AMR) of STIs—in particular gonorrhoea—to antibiotics has increased rapidly in recent years and has reduced treatment options
- The emergence of decreased susceptibility of gonorrhoea to extended-spectrum cephalosporins together with AMR already shown to penicillins, sulphonamides, tetracyclines, quinolones and macrolides make gonorrhoea a multidrug-resistant organism
- AMR for other STIs, though less common, also exists, making prevention and prompt treatment critical.