Effective treatment of sexually transmitted infections (stis): A Synthesis of Findings from 11 Studies

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Original Abstract of the Article

Major Research Findings

Sexually transmitted infections (STIs) are a significant source of morbidity globally, disproportionately impacting the health of women and children. 2 shows that the number of randomized controlled trials (RCTs) testing interventions to prevent STIs has dramatically increased over time. This paper systematically reviewed interventions to prevent sexual transmission or acquisition of STIs other than human immunodeficiency virus, published in the English-language, peer-reviewed literature through December 2009, identifying 93 papers reporting data from 74 RCTs evaluating 75 STI prevention interventions. 2 highlights the effectiveness and challenges of various interventions for STI prevention. For example, treatment interventions and vaccines for viral STIs showed the most consistently positive effects, and male circumcision protected against viral STIs and possibly trichomoniasis. 2 also notes that while behavioral interventions can be effective, the magnitude of effects ranges broadly, and partner services yield similarly mixed results. In contrast, vaginal microbicides and physical barrier methods demonstrated few positive effects. 2 emphasizes that future STI prevention efforts should focus on enhancing adherence within interventions, integrating new technologies, ensuring sustainable behavior change, and conducting implementation research.

7 assesses sexual behavior and incidence of sexually transmitted infections (STIs) among men who have sex with men and transgender women participating in Sabes, a study of an expanded treatment as prevention strategy focused on early diagnosis and treatment of HIV infection in Lima, Peru (2013-2017).

5 investigates the effect of sexually transmitted co-infections on HIV viral load amongst individuals on antiretroviral therapy (ART) through a systematic review and meta-analysis. This paper points out that while ART markedly reduces HIV transmission, testing and treatment programs have been advocated as a method for decreasing transmission at the population level, little is known about the extent to which sexually transmitted infections (STIs), which increase the HIV infectiousness of untreated individuals, may decrease the effectiveness of treatment as prevention.

3 evaluates the predictors and persistence of Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), and Trichomonas vaginalis (TV) infections in men with nongonococcal urethritis (NGU).

11 assesses the effectiveness of text messaging interventions on prevention, detection, treatment, and knowledge outcomes for sexually transmitted infections (STIs)/HIV through a systematic review and meta-analysis.

10 applies the Integrated Behavioral Model (IBM) to measure intention to get early screening and treatment of Sexually Transmitted Infections (STIs) among HIV at-risk sub-populations in Ethiopia.

1 systematically reviews behavioral counseling interventions to prevent STIs in adolescents and adults (nonpregnant and pregnant) for the U.S. Preventive Services Task Force.

6 compares the effectiveness of home-based versus clinic-based specimen collection in the management of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections.

8 discusses empirical treatment and the influence on semen quality of mixed sexually transmitted infections (MSTIs) in infertile couples.

4 examines the efficacy of a novel regimen to prevent recurrent vaginal infections through a randomized trial of periodic presumptive treatment with high-dose intravaginal metronidazole and miconazole in HIV-negative women.

9 demonstrates through a population-based study that nearly half of adults with symptoms of sexually transmitted infections (STIs) did not seek clinical care in Rakai, Uganda.

Treatment Summary

2 shows that treatment interventions and vaccines for viral STIs are most effective. 2 also shows that male circumcision can protect against viral STIs and possibly trichomoniasis. 3 shows that the persistence of Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) infections after treatment is high. 8 points out that treating simultaneous infections of Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), and Ureaplasma urealyticum (UU) in infertile couples can be complicated by the different sensitivities of microorganisms to antibacterial drugs.

Benefits and Risks

Benefits Summary

Treatment interventions and vaccines can be effective in preventing viral STIs. 2

Male circumcision may protect against viral STIs and trichomoniasis. 2

Behavioral interventions can be effective in preventing STIs. 2

Partner services can be effective in preventing STIs. 2

Vaginal microbicides and physical barrier methods may have limited effectiveness in preventing STIs. 2

Risks Summary

Treatment interventions and vaccines can have side effects. 2

Male circumcision has risks of complications. 2

Behavioral interventions may have limited effectiveness. 2

Partner services may have limited effectiveness. 2

Vaginal microbicides and physical barrier methods may have limited effectiveness in preventing STIs. 2

Comparison of Studies

Similarities of Studies

Many studies explore various interventions for STI prevention and treatment.

Differences of Studies

Studies differ in the populations studied, the types of interventions, and the methods of measuring outcomes.

Consistency and Contradictions in Results

Some studies indicate that certain interventions are effective in preventing STIs, while others show limited effectiveness. For example, vaginal microbicides and physical barrier methods may have limited effectiveness in preventing STIs. 2

Considerations for Application in Real Life

Interventions for STI prevention or treatment may not be effective for everyone. The effectiveness of interventions may vary based on individual risk factors and other factors.

Limitations of Current Research

Many studies have a limited number of participants, making it difficult to generalize the results.

Some studies lack sufficient data on the long-term effects of interventions.

Some studies are susceptible to bias, requiring cautious interpretation of results.

Future Research Directions

Further research is needed to investigate the effectiveness of interventions for STI prevention and treatment. In particular, research is needed on long-term effects, various risk factors, and the optimal delivery of interventions.

Conclusion

Sexually transmitted infections are a major health concern worldwide. While various interventions exist for STI prevention and treatment, further research is needed to ensure their effectiveness and safety. To prevent STIs, it is recommended to use condoms during sex, avoid having multiple sexual partners, and get regular STI testing.

Treatment List

Treatment interventions, vaccines, male circumcision, behavioral interventions, partner services, vaginal microbicides, and physical barrier methods

Literature analysis of 11 papers
Positive Content
9
Neutral Content
1
Negative Content
1
Article Type
4
3
5
4
11
1.

Behavioral counseling to prevent sexually transmitted infections: a systematic review for the U.S. Preventive Services Task Force.

Author: LinJennifer S, WhitlockEvelyn, O'ConnorElizabeth, BauerVance

Increased adherence
STI reduction

Behavioral counseling interventions with multiple sessions in STI clinics and primary care effectively reduced STI incidence in high-risk adults and adolescents. While the evidence is modest, these interventions also increased adherence to treatment recommendations and decreased risky behavior.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

2.

Randomized controlled trials of interventions to prevent sexually transmitted infections: learning from the past to plan for the future.

Author: WetmoreCatherine M, ManhartLisa E, WasserheitJudith N

Reduced STI transmission

This systematic review assessed the impact of interventions to prevent sexual transmission or acquisition of STIs other than human immunodeficiency virus.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis infections in men with nongonococcal urethritis: predictors and persistence after therapy.

Author: SeñaArlene C, LensingShelly, RompaloAnne, TaylorStephanie N, MartinDavid H, LopezLaureen M, LeeJeannette Y, SchwebkeJane R

Persistent infection

Persistent Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) after treatment of nongonococcal urethritis (NGU) were common and associated with clinical findings and drug regimen.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

4.

Randomized Trial of Periodic Presumptive Treatment With High-Dose Intravaginal Metronidazole and Miconazole to Prevent Vaginal Infections in HIV-negative Women.

Author: McClellandR Scott, BalkusJennifer E, LeeJeannette, AnzalaOmu, KimaniJoshua, SchwebkeJane, BraggVivian, LensingShelly, KavakLale

Reduced BV

Monthly treatment with intravaginal metronidazole plus miconazole reduced the proportion of visits with bacterial vaginosis (BV).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

5.

The effect of sexually transmitted co-infections on HIV viral load amongst individuals on antiretroviral therapy: a systematic review and meta-analysis.

Author: ChampredonDavid, BellanSteven E, DelvaWim, HuntSpencer, ShiChyun-Fung, SmiejaMarek, DushoffJonathan

HIV prevention

Antiretroviral therapy (ART) can significantly reduce the spread of HIV. While testing and treatment programs are being promoted to reduce HIV transmission, it's unclear how other sexually transmitted infections (STIs), which increase the risk of spreading HIV in untreated people, might affect the effectiveness of treatment as a prevention strategy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Home-based versus clinic-based specimen collection in the management of Chlamydia trachomatis and Neisseria gonorrhoeae infections.

Author: Fajardo-BernalLuisa, Aponte-GonzalezJohanna, VigilPatrick, Angel-MüllerEdith, RinconCarlos, GaitánHernando G, LowNicola

STI control

Chlamydia and gonorrhea are common sexually transmitted infections (STIs). Improving the process of getting people diagnosed and treated for these infections could help control the spread of STIs and reduce complications from untreated or incompletely treated infections.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

7.

Sexual Behavior and Sexually Transmitted Infection Outcomes Among Men Who Have Sex With Men and Transgender Women Participating in a Study of the Timing of Antiretroviral Therapy in Lima, Peru.

Author: MontañoMichalina A, AlfaroRicardo, NessTara, GanozaCarmela, GonzalesPedro, SanchezJorge, LamaJavier R, DuerrAnn C

Early HIV diagnosis
Reduced STI transmission

The study assessed sexual behavior and incidence of sexually transmitted infections (STIs) among men who have sex with men and transgender women participating in Sabes, a study focused on early HIV diagnosis and treatment in Lima, Peru.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Mixed Sexually Transmitted Infections in Infertile Couples: Empirical Treatment and Influence on Semen Quality.

Author: YasynetskyiMykola, BanyraOleg, NikitinOleg, VentskivskaIryna, KozlovVadym, KvachMykola, BorzhievskyyAndrii

MSTIs treatment

Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), and Ureaplasma urealyticum (UU) are common sexually transmitted infections (STIs) found in couples struggling with infertility. When these infections occur together (mixed STIs), treating them becomes more complex because different medications are effective against each infection. Furthermore, because of the complexity of these infections, treatment is often started before knowing which medications will be most effective.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Nearly half of adults with symptoms of sexually transmitted infections (STIs) did not seek clinical care: A population-based study of treatment-seeking behavior among adults in Rakai, Uganda.

Author: OgaleYasmin P, KennedyCaitlin E, NalugodaFred, MpagaziJosephine, JacksonJade C, GaliwangoRonald, SsekubuguRobert, KigoziGodfrey, DenisonJulie A, GaydosCharlotte A, KagaayiJoseph, GrabowskiM Kathryn

STI symptoms

In rural Uganda, nearly half of adults with STI-related symptoms do not seek clinical care, and many who do seek treatment have curable STIs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Effectiveness of text messaging interventions on prevention, detection, treatment, and knowledge outcomes for sexually transmitted infections (STIs)/HIV: a systematic review and meta-analysis.

Author: TaylorDarlene, LunnyCarole, LolićPetra, WarjeOrion, GeldmanJasmina, WongTom, GilbertMark, LesterRichard, OgilvieGina

STI treatment adherence

This meta-analysis of 35 randomized controlled trials (RCTs) evaluated the effectiveness of text messaging interventions for STI/HIV prevention and treatment. While text messaging has potential, the evidence is equivocal. Text messaging increased appointment attendance and HIV testing compared to standard care. However, its impact on adherence to treatment was mixed. More research is needed to ensure text messaging interventions achieve the desired outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

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