International Journal of

Environmental Research
and Public Health

Editorial
Sexually Transmitted Diseases: Diagnosis and Control
Teresa Fasciana *, Giuseppina Capra , Dario Lipari , Alberto Firenze and Anna Giammanco

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties,
University of Palermo, 90127 Palermo, Italy; giuseppina.capra@unipa.it (G.C.); dariolipari79@gmail.com (D.L.);
alberto.firenze@unipa.it (A.F.); anna.giammanco@unipa.it (A.G.)
* Correspondence: teresa.fasciana@virgilio.it

Sexually transmitted diseases (STDs)—or sexually transmitted infections (STIs)—are

generally acquired through sexual contact. The bacteria, viruses or parasites involved are
usually transmitted through sexual contact, including through bodily fluids or skin contact
via vaginal, oral, and anal sex. STDs are a major health problem and mostly affect young
people, not only in developing, but also in developed countries. The burden of disease that
STIs represent globally is unknown for several reasons. Firstly, asymptomatic infections
are common in many STIs; secondly, diagnostic methods are not available in some of the
worst-affected countries; finally, surveillance systems are inexistent or very deficient in
many areas of the world.
Accurate diagnostic tests for STIs are widely used in high-income countries. These are
especially useful for the diagnosis of asymptomatic infections. However, diagnostic tests
are largely unavailable in low- and middle-income countries. Where testing is available,
it is often expensive and geographically inaccessible, and patients often need to wait a long
time (or need to return) to receive results. As a result, follow-up can be impeded, and care
or treatment can be incomplete.
For these reasons, several rapid tests for other STIs are under development and have
the potential to improve STI diagnosis and treatment, especially in resource-limited settings.
Citation: Fasciana, T.; Capra, G.; This Special Issue includes full research articles and reviews focused on the epidemiol-
Lipari, D.; Firenze, A.; Giammanco, A. ogy of STDs and on the specificity and sensibility of diagnostic tests used in the laboratory.
Sexually Transmitted Diseases: Among contributions reporting epidemiology data, Fasciana and coauthors reported a
Diagnosis and Control. Int. J. Environ. retrospective study that describes the sociodemographic profile and main sexual behaviors
Res. Public Health 2022, 19, 5293. of patients attending a hospital in Palermo (Sicily, Italy) as predictors of STI risk. Patients
https://doi.org/10.3390/ijerph19095293 were divided into subgroups: men who have sex with men (MSM), men who have sex with
Received: 21 April 2022
women (MSW), bisexual men, and females. Data were obtained through an anonymous
Accepted: 25 April 2022
questionnaire. Patients were tested for Chlamydia trachomatis, syphilis, Mycoplasma genital-
Published: 27 April 2022
ium infection, genital herpes, and HPV infection. The data obtained showed that the most
common profile of patients attending the clinic was that of an adult, Italian man with a
Publisher’s Note: MDPI stays neutral
high level of education, poor use of condoms, and a high number of partners. MSM had
with regard to jurisdictional claims in
the highest sex-behavior-related risk for STIs. In addition, their results suggest that, in their
published maps and institutional affil-
geographic area, all STD teams need to implement counselling and recommendations to
iations.
share with patients, as well as tips on how to approach sexual health education/counselling,
thereby promoting patient-centered approaches and educational programs [1].
Haag et al. conducted a systematic literature search to determine Chlamydia trachomatis
Copyright: © 2022 by the authors.
prevalence rates, identify risk groups, and delineate chlamydia-testing strategies. Their
Licensee MDPI, Basel, Switzerland. results suggest the use of a counselling as an opportunity to recommend chlamydia testing.
This article is an open access article Future approaches to identify target risk groups might include chlamydia prevalence testing
distributed under the terms and among emergency contraception users attending community pharmacies. Furthermore,
conditions of the Creative Commons to reinforce the pharmacist’s new role as a gateway to health care, further pharmacy-
Attribution (CC BY) license (https:// based services might be developed to target individuals at particular risk for chlamydia
creativecommons.org/licenses/by/ infections in Switzerland, such as individuals with multiple infections including HIV or
4.0/). hepatitis C [2].

Int. J. Environ. Res. Public Health 2022, 19, 5293. https://doi.org/10.3390/ijerph19095293 https://www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2022, 19, 5293 2 of 3

A prospective observational cohort study reported by Wang and coworkers was

conducted among a group of men who have sex with men (MSM) who obtained pre-
exposure prophylaxis (PrEP) in private clinics in Thailand and used it in Hong Kong.
Participants completed two web-based self-administered surveys when obtaining PrEP
in Thailand and three months afterwards. The results obtained showed that participants
who perceived that they had a higher chance of STI infection (adjusted odds ratios (AOR):
1.90, 95% CI: 1.00, 3.75) and reported a higher intention to take up STI testing at baseline
(AOR: 1.62, 95% CI: 1.05, 2.50) were more likely to receive STI testing during the follow-up
period. Baseline perceptions that service providers would think they were engaging in
risky behaviors because of PrEP use was negatively associated with the dependent variable
(AOR: 0.51, 95% CI: 0.31, 0.86). Then, the need for service planning and health promotion
related to STI testing for MSM “PrEP tourists” was underlined by the authors. Finally, the
two papers recommended the implementation of specific programs of information and
education [3].
Another study using anonymous self-administered questionnaires was conducted
by Yamanaka and Kawata. In the paper, the authors report the characteristics of mother–
daughter relationships among Japanese female university students and their associations
with students’ sexual risk awareness. One of the main findings of this study is that sexual
literacy and education about self-management may help to develop close communication
between the mother and daughter and help these relationships in terms of trust and
intimacy. These findings suggest that, as a specialized profession, we need to impress on
society the importance of a good mother–daughter relationship so that young women can
develop self-management abilities to help them avoid sexual risks [4].
In their results, Chan et al. showed that implementing HIV self-testing (HIVST) online
is helpful in increasing HIV testing coverage among men who have sex with men (MSM)
in Hong Kong. In this study, it was observed that about 80% of HIVST-online ever-users
received some form of HIV testing during the study period, and most of them used HIVST-
online again. Therefore, the implementation of HIVST-online has good potential to increase
the regular HIV testing rate, which is very low among Chinese MSM. Regular HIV testing
is important for MSM, as their sexual risk behaviors are continuous [5].
In the review entitled “Current and Future Trends in the Laboratory Diagnosis of
Sexually Transmitted Infections”, Caruso and coauthors provide an updated overview
of the current laboratory diagnostic tools used for these infections, highlighting their
advantages, limitations, and point-of-care (POC) adaptability. The diagnostic applicability
of the latest molecular and biochemical approaches was also reported. In the review,
advances that have been made in the POC testing for STIs are reported, and more tests are
in the pipeline. However, the need remains for the better integration of STI POC testing
into healthcare systems. Due to the hidden nature of STIs, ensuring the extensive and
rapid screening of at-risk people and their partners is pivotal to successfully control these
infections [6].
In conclusion, this Special Issue collects papers with a unique aim: to improve the
strategies used to increase screening and testing for STIs. This should help to better assess
people’s risk of contracting an STIs and help people with STIs access treatment, improving
their health and making it less likely that STIs will be spread to others.

Author Contributions: Data curation, T.F. and G.C.; writing—original draft preparation, T.F., G.C.,
D.L., A.F. and A.G.; writing—review and editing, T.F., G.C., D.L., A.F. and A.G.; visualization, D.L.;
supervision, A.G. All authors have read and agreed to the published version of the manuscript.
Funding: This research received no external funding.
Conflicts of Interest: The authors declare no conflict of interest.
Int. J. Environ. Res. Public Health 2022, 19, 5293 3 of 3

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