Last week, the US FDA granted marketing authorization for the first self-test for chlamydia, gonorrhea, and trichomoniasis. This milestone combined with major strides at the end of 2024—such as a new partnership to expand cervical cancer screening and HPV vaccination programs, along with promising new data indicating the STI epidemic may be slowing in the US—underscores the field’s potential. However, the new US administration is threatening these gains with the gutting of foreign aid, cancellation of dozens of grants focused on vaccine hesitancy and acceptance and take down of the agencies and organizations that survey and collect data on STIs.
As many global health fields reassess their reliance on US government funding for research and development, the STI field—already underfunded and reliant on alternate donors—now faces even greater uncertainty. In this newsletter, we share a new STI resource for advocates and highlight the top issues we’re monitoring as events continue to unfold.
Introducing the New Self-Care Advocacy Guide for HIV and STI Prevention
Self-care, the ability of people to promote and maintain health, prevent disease, and cope with illness and disability with or without the support of a healthcare worker is especially critical now, as the new US administration’s sweeping funding cuts and policy shifts threaten to erode support for traditional healthcare services, including HIV and STI programs. By putting testing, prevention, and treatment directly into people’s hands, self-care can help communities maintain vital health services despite reduced funding, limited access to healthcare, and diminished government support. Read our new guide, Self-Care Advocacy for HIV and STI Prevention.
Priorities, Insights and Resources: AVAC’s Top 5 for 2025
Behavioral & Implementation Science Under Threat
Meningococcal B Vaccine R&D
Doxycycline to Prevent Bacterial STIs (DoxyPEP)
STI Diagnostics Advancements
Recent advancements in point-of-care (POC) testing and lateral flow assays (LFAs) are helping to more effectively and efficiently detect and manage STIs. These diagnostic innovations hold the keys to addressing the global rise in STI rates by enabling timely diagnosis and treatment, which will improve outcomes for people and help reduce transition. Just last week, the US FDA granted marketing authorization for the first self-test for chlamydia, gonorrhea, & trichomoniasis paving the way for other diagnostics. As these diagnostics are being developed, it remains imperative that we advocate for the equitable implementation of these tools. Everyone deserves access to tests that could improve their sexual health and wellbeing.
STI Investments
While STI rates continue to rise, globally, recent US funding and policy changes are threatening progress in developing new diagnostics and vaccines that meet the needs of communities, especially those in resource limited settings. There is an urgent need for sustained support that promotes the development and implementation of STI vaccines and diagnostics. At AVAC, we are anticipating the release of Impact Global Health’s report on sexual and reproductive health investments, including those for STIs. To learn more about STI investments and their impact on STI diagnostics, check out our webinar with Impact Global Health.
Save the Date for the STI & HIV 2025 World Congress
All these issues will likely be on full display at the STI & HIV 2025 World Congress in Montreal, Canada, July 26-30, 2025. AVAC will be there tracking it all. Be sure to register this week to secure the early registration rate.
Spotlight on Advocacy Partner, Elizabeth Zahabu
Elizabeth Zahabu from Tanzania and an AVAC Advocacy Navigator is driving change in STI prevention and treatment through her important community advocacy project in Tanzania. Her report, which you can read more about in this blogpost, highlights findings from a situational analysis she and partners are conducting at Magomeni and Tandale Health Centers in Dar es Salaam, Tanzania. This research is uncovering barriers such as the lack of STI self-testing, high service costs, and age-related provider biases that are preventing access to necessary testing and treatment, especially among Adolescent Girls and Young Women (AGYW). These findings underline the urgent need for advocacy to ensure STI self-testing kits are made available in Tanzania, ideally at no cost, similar to HIV services. “Such measures would improve access, but also enhance confidentiality, and convenience, especially for AGYW and other vulnerable groups,” Zahabu writes. Read more about Elizabeth’s work in this Linked In post.
What We’re Reading
- Association Between Herpes Simplex Virus Type 2 and High-Risk Human Papillomavirus Infections: In an article published in The Journal of Infectious Diseases, authors found that people with HSV-2 infections are more likely to have an HPV infection that could lead to cervical cancer. While research on this correlation remains limited, these findings underscore the importance of vaccination to prevent infections and HPV-related cancer.
- Potential Impact of Doxycycline Post-Exposure Prophylaxis (DoxyPEP) on Resistance: An analysis of gonorrhea isolates published in Clinical Infectious Diseases found that gonorrhea tetracycline resistance increased from 27% in 2023 to 70% in 2024. Tetracyclines are a class of antibiotics that include doxycycline to treat a variety of bacterial infections. While this rise in resistance could be connected with increased doxycycline use in treating chlamydia and non-gonococcal urethritis, evidence also suggests that DoxyPEP is contributing to antimicrobial resistance (AMR). Additional tools are needed to monitor and assess DoxyPEPs impact on AMR.
- Impact of a Potential Chlamydia Vaccine in the US: In a BMJ Health publication, authors estimate that vaccinating 80% of people aged 15-49 years in the US, with a vaccine that reduces susceptibility, infectiousness, or duration of infection by 50% would reduce chlamydia prevalence by 27%–42% over 10 years. As untreated chlamydia infections can lead to pelvic inflammatory disease, infertility, and increase transmission and acquisition of HIV, a vaccine remains ever important.
- FDA Fast Tracks Sanofi’s mRNA Vaccine for Chlamydia: The US FDA granted fast-track designation to Sanofi’s mRNA vaccine candidate to protect against primary genital tract infection and reinfection of chlamydia. Chlamydia is the world’s most common bacterial STI.
- The Conference on Retroviruses and Opportunistic Infections (CROI) wrapped up in March. Read more about the promise of scientific advances, including new research on DoxyPEP, against the backdrop of the US government’s priorities here and here.
⮐ See all issues of the STIWatch newsletter
