One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.

Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.

The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexualityâ€"the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.

This manual provides an authoritative guide to standard laboratory procedures for detecting and diagnosing sexually transmitted diseases. Addressed to clinical microbiologists and medical technologists, the manual is designed to serve as a practical bench aid, tuned to the needs and capacities of laboratories at different levels in the health system. Although the standard procedures described have universal relevance, particular attention is given to conditions in developing countries, where rapid transport of specimens may not be possible and cost factors may be decisive. Recommended procedures, tests, and techniques are supported by close to 150 references. Noting the constraints on staff and resources faced by most laboratories throughout the world, the manual concentrates on tests known to yield essential diagnostic information. Standard antimicrobial susceptibility tests are described for those diseases where drug resistance is a problem. Although the major emphasis is on procedures for diagnosis, case-finding, and test-of-cure, some procedures useful in epidemiological research are also included. The manual has nine chapter covering the full range of sexually transmitted diseases: gonorrhoea "Chlamydia trachomatis "infection, syphilis, genital herpes, chancroid granuloma inguinale, vaginitis in adults, human papillomavirus infection, and human immunodeficiency virus. Each chapter opens with a brief description of the disease and the principal laboratory approaches to diagnosis, followed by detailed advice on the collection and transport of specimens. Against this background, all relevant laboratory methods, from microscopy, culture and non-culture techniques to serology and the use of commercial test kits, are described in detail, with colour plates used to illustrate selected procedures and results. Apart from providing detailed step-by-step instructions for each procedure, the manual offers abundant practical advice on the selection of tests, their comparative sensitivity, and specificity, the degree of skill required, the correct interpretation of results, and common errors and how to avoid them. The chapter on HIV infection reproduces the latest joint UNAIDS and WHO recommendations for the selection and use of HIV antibody tests. Further practical guidance for each of these diseases is provided in three annexes, which summarize appropriate diagnostic tests at different levels of the laboratory system, describe the media, reagents, and stains required for the tests, and list all the basic products needed to prepare essential reagents and media.

This document presents a comprehensive literature review, documenting existing experience with the provision of services for sexually transmitted infections (STIs) to adolescents. It draws from programme experience worldwide, including the following service delivery models: public and nongovernmental organization health services which have been made adolescent-friendly, sexual and reproductive health clinics and multipurpose centres for young people, school-based or school-linked services, and community-based and private sector services.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.