There has been a remarkable surge in the number of reported cases of STIs (sexually transmitted infections). The CDC reported approximately 245,949 new cases of syphilis,1 HIV and hepatitis C virus (HCV)2 in 2022 alone. Syphilis, HIV and HCV affect similar populations, including adolescents and people ages 15 to 24, bisexual and other men who have sex with men, members of certain racial and ethnic minority groups, and increasingly cis women and pregnant people (congenital syphilis).
Moreover, these infectious diseases are syndemic—intersecting epidemics that are not merely concurrent or sequential but also exhibit synergistic relationships through overlapping or interactive risk factors, often within a context of shared social and behavioral vulnerabilities and disparities in healthcare access. Consequently, STIs like syphilis elevate the risk of acquiring HIV and HCV. For example, co-infection with HIV and syphilis varies from 8% to 25%,3,4 depending on the prevalence of both infections within the community. In 2018, the total lifetime medical expenses for 1,896 new HIV infections linked to STIs amounted to $800 million.5
Researchers have identified multiple missed opportunities and barriers in addressing this STI syndemic concerning screening, testing and access to treatment. Adopting a comprehensive whole-of-society strategy that encompasses the mitigation of social and economic obstacles is intrinsically linked to the enhancement of screening and testing in healthcare deserts (notably, maternity care deserts) and unconventional clinical environments, such as utilizing point-of-care testing in community contexts. Therefore, improved access to precise and accessible testing methods is necessary to enable the swift identification of individuals infected with syphilis, HIV and HCV in public health and outreach settings, emergency departments, labor and delivery units, laboratories, physician offices, and at home.
This eBook from OraSure Technologies, a leading organization in infectious disease diagnostics, provides an overview of the rising STI syndemic as well as solutions, workflows, case studies, and insights to improve syphilis, HIV and HCV testing.
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References
1. cdc.gov. Sexually Transmitted Infections Surveillance, 2022. [webpage]
2. cdc.gov. (2024) About AtlasPlus | CDC NCHHSTP. [webpage]
3. Sarigul F, Sayan M, Inan D, et al. (2019). Current status of HIV/AIDS-syphilis co-infections: a retrospective multicentre study. Cent Eur J Public Health. 27(3):223–228. doi:10.21101/cejph.a5467
4. Mata-Marin JA, Sandoval-Sanchez JJ, Huerta-Garcia G, et al. (2015). Prevalence of antibodies against Treponema pallidum among HIV-positive patients in a tertiary care hospital in Mexico. Int J STD AIDS. 26(2):81–85. doi: 10.1177/0956462414530888
5. cdc.gov/sti. (2024). Reversing the rise in STIs: Integrating services to address the syndemic of STIs, HIV, substance use, and viral hepatitis. [Infographic].
