To meaningfully stem the tide of the STI epidemic, the health care system must work together through education, prevention, screening, diagnosis, and treatment.

By Jennifer Schneiders, PhD

Within the realm of public health, laboratory professionals are on the front lines of combating the escalating epidemic of sexually transmitted infections (STIs). The Centers for Disease Control and Prevention (CDC) recently released new data that show there were 2.5 million cases of chlamydia, gonorrhea, and syphilis reported in the U.S. in 2022. Chlamydia and gonorrhea comprised the majority of these infections, and young adults were shown to be particularly vulnerable with almost 50% of cases occurring among those aged 15-24.[1]

The STI epidemic is likely more widespread than the numbers would suggest for two reasons: No. 1, several STIs do not exhibit symptoms; and No. 2, many people who are at risk for STIs are not regularly screened. The CDC data also do not include other STIs on the rise, such as Trichomonas vaginalis (TV) and Mycoplasma genitalium (M. gen), without a surveillance system in place to track and monitor these emerging infections. [2],[3]

If left untreated, chlamydia, gonorrhea, TV, and M. gen can all cause long-term health consequences, especially for young women, such as ectopic pregnancies, pelvic inflammatory disease, and even infertility.[4] These infections can also increase a person’s susceptibility to other STIs, including herpes and HIV.[5]

Evolving Guidelines to Beat the STI Epidemic

Unfortunately, there remains a lack of understanding of the need for regular screening among the general public. Moreover, society tends to minimize the impact of STIs like chlamydia and gonorrhea because we have access to antibiotics. But when people understand the long-term health risks, including infertility, they gain an important perspective. Lab professionals have the opportunity—and responsibility—to help people protect themselves against the serious health consequences of undetected STIs.

By providing timely and accurate test results, lab professionals play an important role in the diagnoses and treatment of STIs, and to help combat the STI epidemic. The work done by lab professionals protects the health of individual women and advances our overall public health goals by breaking the cycle of infection. Your expertise and meticulous attention to detail also means you can help educate health care professionals (HCPs) and keep them informed of the latest screening guidelines.      

Currently, the CDC recommends that sexually active young women aged 15-24 receive annual chlamydia and gonorrhea screening[6]. The agency also recommends annual screening for young men who have sex with men and suggests more frequent screening (every 3 to 6 months) for those at increased risk, including those who are HIV positive or have had more than two partners since their last test.6 While regular screening has not been recommended for most young men who have sex with women, it should be considered for those who get care in high-prevalence settings such as adolescent clinics, STI clinics, and correctional facilities.6

The CDC’s most recent guidelines also suggest that clinicians consider adopting an opt-out approach for chlamydia and gonorrhea screening.7 Providers can normalize STI screening and reduce the stigma associated with these STIs by making it clear that they screen all young women aged 15-24 for these infections—regardless of reported sexual behavior—unless the patient opts out. As more providers adopt this approach, more patients will be screened, thus creating an increased need for well-appointed labs staffed with knowledgeable professionals.  

Likewise, guidelines will continue to evolve as new data becomes available, especially around TV and M. gen, which may lead to additional screening needs. Lab professionals can help educate HCPs in accordance with the most recent screening guidelines.

Partnering with Labs

Hologic is proud to be a trusted partner to lab professionals. For more than three decades, we’ve helped to streamline laboratory workflows with innovative nucleic acid amplification tests (NAAT). We offer a single collection device that can detect up to seven infections and disease states—including bacterial vaginosis, C. glabrata, Candida species, chlamydia, gonorrhea, M. gen, and TV—from just one vaginal swab. Our fully automated system can maximize productivity, reduce cost and complexities in the lab, and offer a more accurate diagnosis the first time—helping patients avoid multiple visits and allowing HCPs to treat STIs sooner.

In order to meaningfully stem the tide of the STI epidemic, the health care system must work together through education, prevention, screening, diagnosis, and treatment. By supporting sexual health testing with innovative technology, Hologic is helping to advance early detection and instill confidence in clinical decisions. We recognize the expertise and steadfast commitment of lab professionals is required to be successful. We hope you will continue to advocate for regular STI screenings to ensure the right patients are screened at the right time.

In turn, Hologic will continue to support our lab and other healthcare partners in the fight against STIs, with the goal of improving patient access and advancing public health. We know that lab professionals have been stretched thin since the pandemic. You deserve our ongoing thanks and gratitude for the work you do, and the real difference you’re making in people’s lives. Thank you for these extraordinary efforts, and we look forward to continuing to partner with you to combat the STI epidemic. 

ABOUT THE AUTHOR

Jennifer Schneiders, PhD, is currently division president of Diagnostics Solutions at Hologic. Prior to that, she served as vice president of U.S. Sales and Commercial Excellence for the Company’s Diagnostics Division. Schneiders joined Hologic in March 2008 upon its acquisition of Third Wave Technologies and has held various roles of increasing responsibility, including vice president, Diagnostic Laboratory Solutions from September 2020 to November 2022 and senior director, Clinical Solutions prior to that.

REFERENCES

[1] Centers for Disease Control and Prevention. February 2024. Sexually Transmitted Infections Surveillance 2022. Atlanta: US Department of Health and Human Services; 2024. https://www.cdc.gov/std/statistics/2022/default.htm

[2] Abraham E., Fairley C.K., Denham I., Bradshaw C.S., Farquharson R.M., et al. November 2022. Positivity and Risk Factors for Trichomonas Vaginalis Among Women Attending a Sexual Health Clinic in Melbourne, 2006 to 2019. Sexually Transmitted Diseases, 49(11):762-768. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553257/

[3] Getman D., Jiang A., O’Donnell M., Cohen S. September 2016. Mycoplasma genitalium Prevalence, Coinfection, and Macrolide Antibiotic Resistance Frequency in a Multicenter Clinical Study Cohort in the United States. Journal of Clinical Microbiology, 54(9):2278-83. https://pubmed.ncbi.nlm.nih.gov/27307460/;

[4] Tsevat D.G., Wiesenfeld H.C., Parks C., Peipert J.F. January 2017. Sexually transmitted diseases and infertility. American Journal of Obstetrics and Gynecology, 216(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193130/

[5] Centers for Disease Control and Prevention. April 2023. STDs and HIV—CDC Detailed Fact Sheet. https://www.cdc.gov/std/hiv/stdfact-std-hiv-detailed.htm

[6] Centers for Disease Control and Prevention. June 2022. Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources. https://www.cdc.gov/std/treatment-guidelines/screening-recommendations.htm

7 Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., et al. 2021. Sexually transmitted infections treatment guidelines, 2021. MMWR Recommendations and Reports, 70(4), 1, p. 14. https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf