Putting the magic in magic bullets: top three global priorities for sexually transmitted infection control.

摘要

Setting practical priorities for sexually transmitted infection (STI) control is a balance between idealism and pragmatism. Infections transmitted through unsafe sex (chlamydia, gonorrhoea, syphilis, HIV hepatitis B and human papillomavirus (HPV) infections) rank in the top five causes of the global burden of disease. Their distribution in populations is driven by a complex mixture of individual behaviours, social and community norms and societal and historical context. Ideally, we would be able to reduce exposure to unsafe sex to its theoretical minimum level of zero and thus eliminate a significant proportion of the current global burden of disease, particularly in resource-poor settings. Ideally, we would have 'magic bullets' for diagnosing and preventing STI in addition to specific antimicrobial agents for specific infections. Arguably, we have 'bullets' that work at the individual level; highly accurate diagnostic tests and highly efficacious vaccines, antimicrobial agents and preventive interventions.