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The impact of STIs.

Continues on page 24 Despite being among the easiest infections to treat — the majority require only a single dose of antibiotic for a complete cure — sexually transmitted infections (STIs) remain an important cause of morbidity in the United States and throughout the world.1 Among the >60 notifiable diseases, the STIs chlamydia and gonorrhea are the two most common.2 These two STIs are the key cause of preventable infertility among women and, along with other STIs (e.g., genital herpes and syphilis), make the acquisition and transmission of human immunodeficiency virus (HIV) infection three to five times more likely.3 Recent developments in diagnosing and treating STIs continue to make this field interesting and worthy of review. Medical laboratories have become increasingly key to diagnosing STIs. Tests previously performed by clinicians (e.g., Gram stain or wet preparation) now are often being performed in the clinical laboratory. In addition, with the advent of nucleic-acid amplification tests (NAATs), more STI tests are of better quality than ever before.4 These tests can be performed on urine or self-collected swabs, increasing the use of these tests in clinical and non-clinical settings. Here, we review clinical, diagnostic, and epidemiologic aspects of the major STIs, except HIV, and also discuss STI prevention and examine challenges and developments for the future.