What is the future of cervical screening in the era of HPV vaccination?

With the introduction of HPV child vaccination programmes, there will have to be a shift from cytology to HPV testing as the main technology involved in primary cervical screening, say the contributors to an on-coming special issue of Preventive Medicine (Tota & Ratnam I) (T&R). Why?  Well, first, because of the inevitable decline in the positive […]

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Cochrane says: Chlamydia screening may have very limited impact, but more research is needed

There is a strong rationale for systematic Chlamydia screening, and it is widely recommended and practised. Yet there are harms associated with the screening process (Low(STIs)), and, of course, serious concerns about its cost-effectiveness (De Wit & Kretzschmar (STIs)).  This lends urgency to the question of whether Chlamydia screening works – addressed in a recently […]

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Is increasing gonorrhoea resistance in MSM is a result of more treatment, rather than greater sexual activity?

Emerging antibiotic resistance to the last-ditch treatment of Neisseria gonorrhoeae compels health policy-makers to balance opposing concerns.  On the one hand, successfully combating spread of the infection requires targeted treatment of core-group individuals.  On the other, a focus on the core-group causes a rebound in core-group incidence, with maximal dissemination of resistance (Chan & McCabe/STIs (C&M); […]

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Can a case be made for opportunistic testing for Chlamydia?

Last month saw the publication of a revised Guidance on Chlamydia Control in Europe (2016) by the European Centre for Disease Prevention and Control.  This replaces the earlier Guidance on Chlamydia Control in Europe (2009) – though the 2016 document refers the reader to the 2009 one for more detailed descriptions of the epidemiology of […]

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Health professionals violate human rights of sex workers in Kenya

  ‘Key’ populations – such as sex workers – are now seen as crucial to turning the tide of the HIV epidemic. Given the recognized epidemiological potential of such marginalized groups to act as ‘bridging populations’ into the wider population, much importance has rightly been attached to countering the kind of routine violations of human […]

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Incidental gonorrhoea screening in the general population via dual NAAT is no benefit

Fifer & Ison (STIs) express concern over the use of the “dual” nucleic acid amplification tests (NAATs) for the detection of chlamydia and gonorrhoea in the context of chlamydia screening in the UK.  Additional testing for gonorrhoea, when the real target is chlamydia, does not necessarily confer an additional net benefit.   This is because even […]

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Universal vv. targeted HIV screening in US EDs

The US Centres for Disease Control and Prevention (CDC) recommends universal “opt-out” HIV screening in all health care settings, including emergency departments and primary care settings (CDC 2006 HIV testing guidelines); the UK Guidelines for HIV Testing (BHIVA, BASHH, BIS) have, since 2008, recommended universal “opt-out-screening” in communities where HIV prevalence ≥ 2 per 1000 […]

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Cervical cancer prevention in low-resource settings: could self-testing be the answer?

A recent paper (Qiao et al.) – Journal of National Cancer Institute (JNCI) 104:3 – reports the findings of a series of 5 population-based studies of self-screening for cervical cancer in rural China, involving 13,140 participants.  They are particularly relevant to STI readers on account of issues they raise about the effectiveness of screening programs […]

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