The U.S. Department of Health and Human Services (HHS) Releases the Sexually Transmitted Infections (STI) Federal Implementation Plan

• From 2014 to 2018, the rates of reported cases of primary and secondary syphilis, congenital syphilis, gonorrhea, and chlamydia rose 71%, 185%, 63%, and 19% respectively¹.
• Human papillomavirus (HPV) is the most common STI and accounts for 14 million new infections annually². HPV infection causes about 35,000 cases of cancer each year, even though there is a safe and highly effective vaccine that prevents the cancer-causing strains of HPV².
• The human and economic consequences of sexually transmitted infections in the U.S. are steep, affecting the quality of life of millions and costing our health care system billions of dollars annually³.
• More than 2.5 million cases of chlamydia, gonorrhea, and syphilis were reported in 2021⁴.

On June 8, 2023, HHS released the STI Federal Implementation Plan to reduce the burden and attempt to reverse the dramatic rise of STIs in the United States. This implementation plan puts forth specific goals and builds on the previous work outlined in the STI National Strategic Plan released on December 17, 2020⁵.

Why is a Plan Necessary?

Increasing numbers of STI cases have grave consequences on the quality of life. If STIs are left untreated, they can lead to long-term, irreversible health conditions such as chronic pelvic pain, infertility, adverse pregnancy outcomes, neonatal deaths, congenital abnormalities, and cancer⁵. The Strategic Plan targets four of the STIs with the highest morbidity rates, the most persistent and pervasive inequalities of STI burden, and the greatest impact on the health of the nation: chlamydia, gonorrhea, syphilis, and human papillomavirus (HPV)².

The Strategic Plan has five goals²:

1. Prevent new sexually transmitted infections.
2. Improve people’s health by reducing adverse outcomes from STIs.
3. Accelerate progress in STI research, technology, and innovation.
4. Reduce STI-related health disparities and inequities.
5. Achieve integrated, coordinated efforts that address the STI epidemic.

The plan seeks a unified approach and calls for the active participation of state, tribal, local, and territorial health departments in conjunction with health plans, health care providers, schools, community and faith-based organizations, scientists, researchers, and the general public.

Planned Actions⁵

The STI Federal Implementation Plan lists over two hundred actions to meet the five goals of the Strategic Plan. The actions listed below are just a few of the planned activities to achieve each goal:

1. Prevent new sexually transmitted infections.

• Develop culturally sensitive and linguistically appropriate educational campaigns to promote sexual health, STI primary prevention, testing, and treatment to reduce STI-associated stigma.
• Support a non-stigmatizing, comprehensive approach to sexual health education and sexual wellbeing, especially in adolescents and young adults, that promotes healthy sexual development and relationships and includes both risk-avoidance and risk-reduction messaging at the community level in schools, faith-based organizations, and other community-based organizations.
• Integrate STI messaging into existing public health campaigns and strategies.

 

2. Improve people’s health by reducing adverse outcomes from STIs.

• Integrate STI screening, diagnosis, care, and treatment as a routine part of a wide variety of programs and settings including those that screen, diagnose, and treat people for other whole health and public health issues such as primary care, urgent care, emergency departments, pediatrics, family planning, HIV, viral hepatitis, substance use disorders, correctional facilities, and school-based health centers.
• Support expanded staffing and the role of disease intervention specialists in programs and settings that serve communities and populations disproportionately impacted by STIs.
• Reduce systems and financial barriers to receiving STI testing, care, and treatment, including those related to laboratory services and coverage for point-of-care testing, self-collected testing, extragenital testing, expedited partner therapy, and partner services.

 

3. Accelerate progress in STI research, technology, and innovation.

• Increase research to improve understanding of STI pathogenesis, immunity, and correlates of protection.
• Develop and leverage academic, public, and private partnerships for vaccine development, approval, and manufacture.
• Ensure vaccine development and distribution is rooted in racial, ethnic, and sexual and gender identity equity and is community-informed to best serve those disproportionally affected by STIs.

 

4. Reduce STI-related health disparities and inequities.

• Support and encourage training of health care and health systems personnel in cultural sensitivity, bias, discrimination, and disparities associated with STIs.
• Work with communities to address misconceptions and reduce stigmas that negatively affect STI prevention, screening, testing, care, and treatment.
• Promote privacy and confidentiality of individual personal health and public health records, especially for adolescents and young adults.

 

5. Achieve integrated, coordinated efforts that address the STI epidemic.

• Strengthen and expand existing surveillance infrastructure and methods including the capacity for more real-time data sharing between public health authorities and health care providers.
• Establish and scale up the integration of STI-related efforts, policies, and programs involving all components of the epidemic.
• Integrate STI prevention, screening, testing, care, and treatment in funding opportunities that address other components of the epidemic.

Progress Indicators⁵

The Federal Implementation Plan identified seven core indicators and seven disparity indicators to measure progress beginning in 2020 with annual monitoring until 2030.

1. Core Indicators

• Increase the percentage of adolescents aged 13–17 years who receive the routinely recommended doses of the HPV vaccine.
• Reduce primary and secondary syphilis rates.
• Reduce congenital syphilis rate.
• Reduce gonorrhea rate.
• Increase chlamydia screening in sexually active females aged 16–24 years.
• Reduce PID [pelvic inflammatory disease] in females aged 15–24 years.
• Increase condom use among sexually active high school students.

 

2. Disparity Indicators

• Reduce primary and secondary syphilis rates among men who have sex with men.
• Reduce congenital syphilis rate among African Americans/Blacks.
• Reduce congenital syphilis rate among American Indians and Alaska Natives.
• Reduce congenital syphilis rate in the West.
• Reduce gonorrhea rate among African Americans.
• Reduce gonorrhea rate in the South.
• Increase condom use among sexually active high school-aged men who have sex with men.

 

Conclusion

STIs are a complex epidemic and a critical national public health concern. This Implementation Plan details federal actions supporting the priorities outlined in the 2020 Strategic Plan. This Plan reflects a commitment to accelerate and focus efforts on the populations, places, and actions that will have the greatest impact in achieving that goal⁵. Contributions from stakeholders from all sectors of society are needed to help achieve the goals of the Strategic Plan to slow down or hopefully reduce the growth of STIs in the United States.

 

DTPM’s Mission

DTPM offers advanced diagnostic testing solutions for laboratories in support of testing for sexually transmitted infections. Our goal is to provide clear, accurate information that empowers clinicians to make the most informed decisions for their patients.

The following DTPM test kits are available:

• Human Papillomavirus Molecular Testing Kit
• Sexually Transmitted Infection Molecular Testing Kit. This kit contains assays designed to detect Chlamydia trachomatis, Gardnerella vaginalis, Haemophilus ducreyi, Herpes simplex 1, Herpes simplex 2, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Treponema pallidum, Trichomonas vaginalis, and Ureaplasma urealyticum

General testing supplies such as gloves, lint-free wipes, and pipette tips are also available via our online store. Contact us today to learn how DTPM can help your laboratory provide testing capabilities for sexually transmitted infections.

 

On August 1, 2023   /   Articles, What's New