21 May 2020
The 21st century rise of STIs
In a review article published today in the New England Journal of Medicine, researchers from the Peter Doherty Institute for Infection and Immunity (Doherty Institute) and Melbourne Sexual Health Centre (MSHC) describe a resurgence of new and re-emerging STIs unlike anything seen in almost 50 years.
Lead author, University of Melbourne Professor Deborah Williamson, Deputy Director of the Microbiological Unit Public Health Laboratory and Director of Clinical Microbiology at the Doherty Institute (a joint venture between the University of Melbourne and The Royal Melbourne Hospital) said the explosion of infections was widespread in high income countries and with men who have sex with men, fuelled by modern advances and their influence on sexual behaviour.
“The landscape of STIs has completely changed in recent years’ Professor Williamson said.
“Increased risks to sexual health include connecting through dating apps and websites, the rate of change in sexual partners, unprotected sex and global spread through international travel.”
While technology has played a part in the global spread of STIs, it also has an important role to play in their prevention, diagnosis and treatment.
“In the last five years, the advent of HIV pre-exposure prophylaxis (PrEP) has transformed the way we approach treating and testing for HIV. We’ve also gained incredible insights in the area of genomics, which is revolutionising our understanding of sexually transmitted infections,” said Professor Williamson.
PrEP is a highly effective HIV prevention method, whereby HIV negative people take HIV medication to significantly reduce their risk of contracting the virus.
The researchers found that many STIs were becoming resistant to antibiotics, including gonorrhea and Shigella - a highly contagious intestinal bacteria that causes dysentery.
They urged the public health community to work in collaboration with the public to stem the tide, including a seamless integration of laboratory testing, public health measures, public messaging and policy making.
“We know from the global response to HIV infection that we can adequately control STIs through genuine partnership among governments, non-governmental organisations, the private sector and the community. It’s essential that we work hand-in-hand on this issue to re-orient the trajectory that we’re on.”