About one in 25 people worldwide had at least one curable, sexually transmitted nonviral infection in 2016, the World Health Organization (WHO) said in a report. The incidence of gonorrhea, chlamydia, trichomoniasis and syphilis amounts to about one million new infections each day, and more than 376 million new cases annually, reported Melanie Taylor, MD, a medical epidemiologist at the WHO Department of Reproductive Health and Research, and colleagues. Moreover, there has been no substantial decline in the number of new infections since the data was last updated in 2012, Taylor noted at a press conference about the report, which was published online in the Bulletin of the World Health Organization. "We cannot sweep [sexually transmitted infections] under the carpet and pretend they don't exist," said Teodora Wi, MD, Medical Officer on STIs, at WHO's Department of Reproductive Health and Research. "We continue to stigmatize people living with STIs, we neglect their care and we fail in prevention." Wi charged healthcare professionals to "normalize the discussion" with their patients about sex, and to "treat STIs like any other infection." "Patients need to be open about their sexuality, receive appropriate care, get educated about protection and getting tested," she said. Wi spoke about the contrast between sex being "more accessible" (via dating apps) at the same time as people are becoming "more complacent" about protection. She contrasted the fears about the HIV epidemic in the 1980s with today: fewer adolescents are worried about HIV, and condom use is declining among those at risk for the disease, thanks to pre-exposure prophylaxis. As a result, "we are seeing more unprotected sex and more STIs," she said. Wi also urged policymakers to support STI services and researchers to find better ways to diagnose and treat sexually transmitted infections, including cheaper, affordable point-of-care tests. Study Details For prevalence estimates on chlamydia, gonorrhea, and trichomoniasis, Taylor and colleagues searched for studies from 2009 to 2016, and found 130 eligible studies. Prevalence estimates on syphilis were generated using Spectrum-STI, the authors said. Global prevalence estimates rose for trichomoniasis from 2012 to 2016 (5.0% to 5.3%, respectively) and for gonorrhea (0.8% to 0.9%, respectively) among women, while chlamydia ticked down (4.2% to 3.8%) and syphilis remained flat at 0.5%. Among men, global prevalence of gonorrhea ticked up (0.6% to 0.7%, respectively), while chlamydia, trichomoniasis, and syphilis estimates remained flat (2.7%, 0.6%, and 0.5%, respectively). In the WHO Region of the Americas, however, chlamydia prevalence spiked from 1.8% in 2012 to 3.7% in 2016 among men. Prevalence of syphilis and gonorrhea also edged up (0.7% to 0.9% and 0.7% to 0.8%, respectively). Among women in this region, chlamydia prevalence dropped from 7.6% to 7.0%, while syphilis rose from 0.7% to 0.9% and gonorrhea from 0.8% to 0.9%. Globally, total estimated incident cases for 2016 were about 172 million chlamydia cases, 156.0 million trichomoniasis cases, 86.9 million gonorrhea cases, and 6.3 million syphilis cases, the authors said. Taylor characterized global STIs as a "hidden, silent, dangerous" epidemic, noting that STIs are still "persistent" globally, despite an increase in education about the dangers of sexually transmitted infections. She added that it's not just stigma and shame that keep people from treatment -- many patients do not realize they are infected. This is especially dangerous for pregnant women, Taylor said, as mothers can transmit these infections to their infants -- leading to stillbirth, neonatal death, and ectopic pregnancy. "[These numbers] indicate that people are taking risks with their sexuality and their reproductive health," she said. Taylor noted that these figures were only for the four sexually transmitted infections listed, and did not include data on prevalence estimates for viral STIs such as HIV, hepatitis B, and herpes. Source
