Sexually transmitted infections (STIs) Treatment

Effective treatment is currently available for several STIs.

Three bacterial STIs (chlamydia, gonorrhoea and syphilis) and one parasitic STI (trichomoniasis) are usually curable with existing, effective single-dose or multiple-dose regimens of antibiotics.

For viral STIs (HIV, HSV and HTLV-1), the most effective medications available are antivirals or anti-cancer drugs (in the case of HTLV-1), that can modulate the course of the diseases, though they cannot cure these three diseases.

Antimicrobial resistance (AMR) to antibiotics used to treat STIs, in particular gonorrhoea, has increased rapidly in recent years and has reduced successful treatment outcomes. Results from the current Gonococcal AMR Surveillance Programme (GASP) show trends of high rates of quinolone resistance, increasing azithromycin resistance and emerging resistance of extended-spectrum cephalosporins.

The emergence of decreased susceptibility of gonorrhoea to extended-spectrum cephalosporins, together with established high-levels of resistance to penicillins, sulphonamides, tetracyclines, quinolones and macrolides make gonorrhoea a multidrug-resistant organism. AMR for other STIs, though less common, also exists, making prevention and prompt treatment critical.

To adequately treat STIs it is important to take the appropriate antimicrobials, with the correct dose and duration for the specific STI to ensure adequate treatment or cure, and to prevent the development of antimicrobial resistance.

Sexually transmitted infections

Sexually transmitted infections (STIs) are spread predominantly by unprotected sexual contact. Some STIs can also be transmitted during pregnancy and childbirth and through infected blood or blood products.

STIs have a profound impact on health. If untreated, they can lead to serious consequences including neurological and cardiovascular disease, infertility, ectopic pregnancy, stillbirths, and increased risk of Human Immunodeficiency Virus (HIV). They are also associated with stigma, domestic violence, and affects quality of life.

The majority of STIs have no symptoms. When they are present common symptoms of STIs are vaginal or urethral discharge, genital ulcer and lower abdominal pain.

The most common and curable STIs are trichomonas, chlamydia, gonorrhoea and syphilis. Rapidly increasing antimicrobial resistance is a growing threat for untreatable gonorrhoea.

Viral STIs including HIV, genital herpes simplex virus (HSV), viral hepatitis B and C, human papillomavirus (HPV) and human T-lymphotropic virus type 1 (HTLV-1) lack or have limited treatment options. Vaccines are available for hepatitis B to prevent infection that can lead to liver cancer and for HPV to prevent cervical cancer. HIV, HSV and HTLV-1 are lifelong infections: for HIV and HSV there are treatments that can suppress the virus, but currently there are no cures for any of these three STIs.

Condoms used correctly and consistently are effective methods to protect against STIs and HIV. Screening with early diagnosis of people with STIs and their sexual partners offers the best opportunity for effective treatment and for preventing complications and further transmission