DATE: January 24, 2019
TIME: 10:00am PST

Sexually transmitted infections (STIs) continue to affect most sexually active populations across the globe, especially the traditional high-risk groups for bacterial STIs such as young people, men who have sex with men (MSM) and individuals from black and minority ethnic populations. Bacterial STIs such as Gonorrhoea and Chlamydia remain common. In western settings, we have observed the re-emergence of high rates of syphilis and lymphogranuloma venereum, mostly in MSM. Urethral and vaginal discharge syndromes, genital ulcer disease are frequent clinical presentations. However, the development of highly sensitive molecular assays has revealed that asymptomatic infections are also common, particularly at extragenital sites, and probably drive transmission of STIs. Management is best guided by the detection of organisms, but treatment is often prescribed based on observed syndromes to cover common causative organisms, before definitive diagnostic results are available or in the absence of diagnostic tests. This has become much more challenging due to increasing rates of antimicrobial resistance among some organisms, especially for Neisseria gonorrhoeae and Mycoplasma genitalium. More than ever, we rely on accurate and patient-focussed diagnostic strategies to detect and treat STIs, with partner notification being an integral component to interrupt transmission within the population.

Learning Objectives:

• Understand the latest epidemiological trends for the major STIs with focus on high-risk groups including MSM.
• Be aware of recent developments in diagnostic tests for STI pathogens, particularly the advantages of molecular assays and the importance of the extragenital reservoirs.
• Appreciate the challenges of treating bacterial STIs in an era of increasing antimicrobial resistance, especially for Neisseria gonorrhoeae and Mycoplasma genitalium.