Sexually transmitted infections: control strategies

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Abstract
Clinical Review p 1160 Sexually transmitted infections, including HIV and hepatitis B, remain one of the greatest global public health challenges. Over the past five years notable rises have been observed in the United Kingdom in the incidence of genital chlamydial infection (76%), gonorrhoea (55%), and infectious syphilis (54%)1; such sustained rises have not been seen since the late 1960s and 1970s.2 Similar increases have also been seen in other countries in Western3 and Eastern4 Europe and the United States.5 The highest rates of sexually transmitted infections occur among 16-24 year olds, particularly older teenagers.1 Ethnic and socioeconomic inequalities in sexually transmitted infection rates exist in the US5 and the UK,6 with higher rates among black ethnic groups and lower socioeconomic groups. If we are to reverse these trends and reduce inequalities we need to understand their underlying determinants. Some rises may reflect improved detection, particularly for genital chlamydial infection (with new diagnostic technologies), and deteriorating healthcare infrastructure (in the former states of the USSR). However, the major factor behind the …