title: Toward global prevention of sexually transmitted infections (STIs): the need for STI vaccines.
abstract: An estimated 499 million curable sexually transmitted infections (STIs; gonorrhea, chlamydia, syphilis, and trichomoniasis) occurred globally in 2008. In addition, well over 500 million people are estimated to have a viral STI such as herpes simplex virus type 2 (HSV-2) or human papillomavirus (HPV) at any point in time. STIs result in a large global burden of sexual, reproductive, and maternal-child health consequences, including genital symptoms, pregnancy complications, cancer, infertility, and enhanced HIV transmission, as well as important psychosocial consequences and financial costs. STI control strategies based primarily on behavioral primary prevention and STI case management have had clear successes, but gains have not been universal. Current STI control is hampered or threatened by several behavioral, biological, and implementation challenges, including a large proportion of asymptomatic infections, lack of feasible diagnostic tests globally, antimicrobial resistance, repeat infections, and barriers to intervention access, availability, and scale-up. Vaccines against HPV and hepatitis B virus offer a new paradigm for STI control. Challenges to existing STI prevention efforts provide important reasons for working toward additional STI vaccines. We summarize the global epidemiology of STIs and STI-associated complications, examine challenges to existing STI prevention efforts, and discuss the need for new STI vaccines for future prevention efforts.
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. Electronic address: gottliebs@who.int.
authors.forename: Sami L
authors.initials: SL
authors.lastname: Gottlieb
authors.affiliation: Department of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Low
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Newman
authors.affiliation: Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Bolan
authors.affiliation: Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Kamb
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Broutet
mesh_terms: D017281:Cost of Illness; D014943:Global Health; D006801:Humans; D011634:Public Health; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D014611:Vaccination / Q000639:trends; D014612:Vaccines
chemical_list: D014612:Vaccines
keywords: Prevention and control; Sexually transmitted diseases; Vaccines