The American Sexual Health Association is observing September as Sexual Health Month, in keeping with the World Association for Sexual Health designation of World Sexual Health Day. Sexually transmitted infections (STIs) are by far the most widespread sexual health conditions affecting both women and men. The Centers for Disease Control estimates that there are approximately 20 million new cases of STIs in the United States annually. STIs can pose serious health issues, especially for women, because they may progress to pelvic inflammatory disease (PID), infertility and cervical cancer.
The Number and Variety of Pathogens Make It Challenging to Address STIs
Controlling STIs is challenging because of the variety of pathogens and the proliferation of strains, including high-risk and drug-resistant variants. Bacterial pathogens include Neisseria gonorrhea (NG), Chlamydia trachomatis (CT) and the Treponema pallidum subpecies pallidum (Tp pallidum), responsible for syphilis. Mycoplasma genitalium (MG) is another bacterial STI that is less known but more common than gonorrhea. Viral pathogens affecting sexual health include human papillomavirus (HPV), herpes simplex virus 2 (HSV-2) and human immunodeficiency virus (HIV). Infections with the protozoan Trichomonas vaginalis (TV) are also common.
The development of effective vaccines for high-risk strains of human papillomavirus (HPV) is a major success story in the recent history of sexual health. However, control of HPV remains limited. Only about 48% of adolescents in the US are vaccinated. Furthermore, existing antivirals are not recommended for treatment of HPV infections. Treatment of HPV lesions or warts is ablative or immunomodulatory.
Drug-Resistant STIs Threaten Public Health
Antibiotic treatment of the leading bacterial STIs is another major success story, but emergent threats like MG and multidrug-resistant versions of more familiar STIs pose new challenges for detection and treatment. For example, screening tests for gonorrhea and chlamydia are widely used but tests for MG are not. The need for effective therapeutics for multi-drug resistant bacterial and protozoan STIs is pressing. In Antibiotic Resistance Threats in the United States, 2013, drug-resistant gonorrhea was one of three threats that CDC designated as urgent.
Health Decisions’ Wish for Sexual Health Month
Health Decisions’ wish for sexual health month is for an opportunity to test a new generation of STI diagnostics, prophylactics and therapeutics. The Health Decisions clinical team has conducted studies of a variety of STI diagnostics, including tests for high-risk HPV, chlamydia and gonorrhea. Our experience also includes conducting studies of vaginal microbicides, antivirals for HIV and antibiotics for bacterial infections of the reproductive system. Health Decisions considers studies of novel products to detect, prevent or treat STIs a top priority because sexual and reproductive health are essential for the well-being of women and men worldwide.