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Heart-sink topics in sexually transmitted infections: vaccinations, anal cancer screening and overlapping infection epidemics in Eastern Europe.

This edition of Current Opinion in Infectious Diseases: Sexually Transmitted Diseases covers three areas of heart-sink for sexual healthcare providers and anyone with an interest in global public health, particularly for men who have sex with men (MSM) and women in their childbearing years in Eastern Europe. This edition offers hope for some of these long-standing problems but there is pessimism regarding parts of Eastern Europe. Gottlieb and Johnston (pp. 77–86) describe the negative views of the WHO in 1989 regarding vaccination for sexually transmitted infections (STIs) [1] and contrast those views with the dramatic developments and new realities that have occurred since then. Although only hepatitis B and human papillomavirus (HPV) vaccines are in routine use – in itself a remarkable achievement since 1989 – we now have realistic goals with a roadmap [2,3] to guide researchers, policy makers, epidemiologists and clinicians. Herpes simplex virus (HSV) type 2 vaccinations, both therapeutic and preventive, some with cross-reaction to type 1, are in phase 1 and 2 trials [4], with success in this field having the potential to improve the lives of those with genital HSV not only by prevention of recurrences in the individual but also by prevention of transmission to their partners and prevention of neonatal infection. At a population level, a reduction in HSV would assist in control of the HIV epidemic as HSV is a major driver of HIV acquisition through genital ulceration and immune activation [5]. The recent identification of tissue-resident memory T cells [6] appears to be a game changer for Chlamydia trachomatis vaccine as a result of recent methods of vaccine development such as immunoproteomics, leading to identification of the relationship between major histocompatability complex class II peptides and outer membrane proteins [7]; in addition, Major outer membrane