Prevention and Control of Sexually Transmitted Infections in the United States

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One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action.

In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.

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750 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-68395-5
ISBN Ebook: 0-309-68396-3
DOI: https://doi.org/10.17226/25955

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National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press.

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Sten H. Vermund

Sten H. Vermund, M.D., Ph.D., serves as Dean of the Yale School of Public Health, Anna M.R. Lauder Professor of Public Health (Epidemiology of Microbial Diseases), and Professor of Pediatrics, Yale School of Medicine. His research has focused on health care access in low-income nations, adolescent sexual and reproductive health, and prevention of mother-to-child HIV transmission. Dr. Vermund’s early work included illumination of the importance of HIV infection in HPV-mediated cervical pathogenesis. He is a member of the National Academy of Medicine. Dr. Vermund received his M.D. from the Albert Einstein College of Medicine at Yeshiva University and his Ph.D. from Columbia University.

Madina Agenor

Madina Agénor, Sc.D., M.P.H., is the inaugural Gerald R. Gill Assistant Professor of Race, Culture, and Society in the Department of Community Health at Tufts University. She is also the Director of the Sexual Health and Reproductive Experiences (SHARE) Lab at Tufts University and adjunct faculty at The Fenway Institute. As a social epidemiologist and health services researcher, Dr. Agénor investigates health and health care inequities in relation to various dimensions of social inequality—especially sexual orientation, gender identity, and race/ethnicity—using an intersectional lens. Specifically, she uses quantitative and qualitative research methods to elucidate the patient-, provider-, and policy-level social determinants of sexual and reproductive health and cancer screening and prevention among marginalized U.S. populations, especially women and girls of color, sexual minority women and girls, transgender and non-binary individuals, and lesbian, gay, bisexual, transgender, and queer (LGBTQ) people of color. As the Principal Investigator of a career development (K01) award from the National Cancer Institute, she is examining how Medicaid state expansions influence sexual orientation and racial/ethnic disparities in human papillomavirus (HPV) vaccination and other sexual and reproductive health outcomes among U.S. women. She is also exploring health care providers’ beliefs, attitudes, decision-making processes, and practices related to HPV vaccination among sexual minority women and women of color in the United States. Further, as a Research Education Institute for Diverse Scholars (REIDS) Fellow at the Center for Interdisciplinary Research on AIDS at Yale University, she is leading a mixed-methods study examining the multilevel social determinants of HIV and sexually transmitted infection (STI) testing among transmasculine U.S. young adults. Prior to joining the Tufts faculty, Dr. Agénor was Assistant Professor of Social and Behavioral Sciences at Harvard T.H. Chan School of Public Health. She holds a Doctor of Science (Sc.D.) in Social and Behavioral Sciences from Harvard T.H. Chan School of Public Health and a Master of Public Health (M.P.H.) from Columbia University’s Mailman School of Public Health, and was a Cancer Prevention Postdoctoral Fellow at Harvard T.H. Chan School of Public Health and Dana-Farber Cancer Institute.

Cherrie Boyer

Cherrie B. Boyer, Ph.D., FSAHM, is a professor of pediatrics in the Division of Adolescent and Young Adult Medicine at the University of California, San Francisco. She also serves as the associate division director for research and academic affairs. Dr. Boyer is an internationally recognized health psychologist with 30 years of research experience in the area of adolescent and young adult health. She has been the recipient of many grant awards and has been a productive investigator, publishing widely in the area of sexually transmitted infections (STIs) and HIV prevention in adolescents and young adults. Dr. Boyer’s program of research focuses on the development and evaluation of cognitive-behavioral and community-level intervention strategies utilizing both culturally competent and positive youth development frameworks to promote sexual health and to reduce the risk of STIs, HIV, and unintended pregnancy and their sequelae in adolescents and young adults. Such interventions have been implemented in various groups, including high school students, teen and STD clinic patients, among at-risk youth residing in high STI prevalent urban neighborhoods, and military personnel, both domestically and internationally. Moreover, for a 10-year period, Dr. Boyer was a member of the NIH-funded Adolescent Trials Network, where she served as a lead investigator and collaborated on a number of community-based participatory research community mobilization studies to examine social determinants and structural barriers to improve HIV prevention for at-risk youth and linkage, engagement, and retention in long-term HIV health care for HIV-infected youth. She has recently conducted research with the San Francisco Department of Public Health Community Equity Prevention Section to identify and characterize factors associated with the disproportionately high rate of STIs in African American adolescents in San Francisco. Other research examines social determinants and other environmental influences on pre-exposure prophylaxis (PrEP) access and up-take in African American and Latin/x young adult men in San Francisco. The end goal of both components of research is to identify health promotion and prevention strategies to reduce the high burden of STIs and HIV and their sequelae in these groups of young people. Dr. Boyer earned her M.A. and Ph.D. from the State University of New York at Stony Brook (now Stony Brook University).

Myron S. Cohen

Myron S. Cohen, M.D., is the Yeargan-Bate Eminent Professor of Medicine, Microbiology, and Immunology and a professor of epidemiology at the University of North Carolina at Chapel Hill. He is the director of the Institute for Global Health and Infectious Diseases. Dr. Cohen is also associate director of the UNC Center for AIDS Research and Associate Vice Chancellor for Global Health and Medical Affairs. Dr. Cohen’s research focuses on the transmission and prevention of HIV, with emphasis on the role played by sexually transmitted infections and co-infections. Dr. Cohen is the architect and principal investigator of the multinational HIV Prevention Trials Network study (HPTN052) that demonstrated that antiretroviral treatment prevents the sexual transmission of HIV-1. He is a member of the American Society of Clinical Investigation, the American Association of Physicians, and the National Academy of Medicine. He earned his M.D. from Rush Medical College.

Jeffrey S. Crowley

Jeffrey S. Crowley, M.P.H., is a distinguished scholar and the program director of infectious disease initiatives at the O’Neill Institute for National and Global Health Law at Georgetown Law. Mr. Crowley is a widely recognized expert on HIV/AIDS and disability policy. His research has covered a range of health policy issues with an emphasis on Medicaid and Medicare policy, especially as these programs impact people with HIV and other disabilities. Mr. Crowley previously served as the director of the White House Office of National AIDS Policy and senior advisor on disability policy for President Barack Obama. In this capacity, he led the development of our country’s first domestic National HIV/AIDS Strategy for the United States. He also coordinated disability policy development for the Domestic Policy Council and worked on the policy team that spearheaded the development and implementation of the Affordable Care Act. Mr. Crowley has also served as an informal resource and counsel for Congressional staff, and he advised national consumer coalitions, including the HIV Health Care Access Working Group and the Consortium for Citizens with Disabilities. He is an alumnus of the United States Peace Corps, where he served as a volunteer/high school science teacher in eSwatini. Mr. Crowley received his M.P.H. from the Johns Hopkins Bloomberg School of Public Health.

Charlotte A. Gaydos

Charlotte A. Gaydos, Dr.P.H., M.P.H., is a professor in the Division of Infectious Diseases of the Johns Hopkins University School of Medicine. She has joint appointments in emergency medicine and in epidemiology and population and family health at the Johns Hopkins Bloomberg School of Public Health. She is a member of the Johns Hopkins University Center for Global Health and directs the Center for Point-of-Care Tests for Sexually Transmitted Diseases and the International STI, Respiratory Diseases, and Biothreat Research Laboratory at Johns Hopkins. She has 50 years of laboratory expertise in microbiology. In the past, Dr. Gaydos conducted multiple FDA clinical trials for new diagnostics for sexually transmitted infections and respiratory pathogens. Her laboratory is a core diagnostic/reference laboratory for international studies of sexually transmitted infections, respiratory diseases, and trachoma. Dr. Gaydos has extensive laboratory experience in the development and evaluation of molecular amplification testing techniques for respiratory, urogenital, and biothreat specimens, as well as epidemiology expertise. Dr. Gaydos has performed original research developing DNA amplification tests for Chlamydia trachomatis, C. pneumoniae, C. psittaci, Trichomonas vaginalis, N. gonorrhoeae, Mycoplasma genitalium, and the agents of genital ulcer disease. She invented, developed, and published an internet STI educational and home screening website, “I Want the Kit,” which has screened over 7,500 women and 3,500 men with self-collected urogenital samples. Dr. Gaydos received her M.S. from West Virginia University and her M.P.H. and Dr.P.H. from Johns Hopkins Bloomberg School of Public Health.

Vincent Guilamo-Ramos

Vincent Guilamo-Ramos, Ph.D., M.P.H., LCSW, RN, ANP-BC, AAHIVS, is a professor and Associate Vice Provost of Mentoring and Outreach Programs at New York University (NYU). He is the director and founder of the Center for Latino Adolescent and Family Health. Dr. Guilamo-Ramos also serves as the Pilot and Mentoring Core Director at the Center for Drug Use and HIV Research at the NYU School of Public Health. Dr. Guilamo-Ramos is a clinical social worker and nurse practitioner, and is board certified in HIV/AIDS nursing (ACRN) and as a HIV specialist (AAHIVS). Clinically, he has expertise in the primary care of HIV positive adolescents, provision of pre-exposure prophylaxis for high-risk youths, and screening and treatment of sexually transmitted diseases. Dr. Guilamo-Ramos studies the role of families in promoting adolescent health, with a special focus on preventing HIV/AIDS, sexually transmitted infections, unplanned pregnancies, and improving treatment outcomes for HIV positive and at-risk youth. He is a Fellow of the American Academy of Social Work and Social Welfare. He serves as Vice Chair of the Board of Directors for the Latino Commission on AIDS, and is a board member of Power to Decide. Dr. Guilamo-Ramos received his Ph.D. from SUNY Albany and his M.S.W. and M.P.H. degrees from NYU. In addition, he holds an M.S. from the Robert F. Wagner Graduate School of Public Service at NYU and an M.S.N. from the Duke University School of Nursing.

Edward W. Hook, III

Edward W. Hook III, M.D., is an emeritus professor of medicine at the University of Alabama at Birmingham, where he was previously a professor of medicine and microbiology in the School of Medicine and a professor of epidemiology in the School of Public Health. Dr. Hook is co-director of the University of Alabama at Birmingham’s Interdisciplinary Center for Social Medicine and STDs. He is also a senior scientist at the UAB AIDS Center, the Minority Health and Research Center, and the Arthritis and Musculoskeletal Disease Center. Dr. Hook was previously the medical director of the sexually transmitted diseases control program at the Jefferson County Health Department in Birmingham, where he remains a contract physician. As an internist with subspecialty expertise in infectious diseases, much of Dr. Hook’s academic career has been focused on management and prevention of sexually transmitted diseases (STDs). In this context he has directed public health STD control programs in two cities (Birmingham, Alabama, and Baltimore, Maryland); directed clinical studies with operational and epidemiologic endpoints; directed clinical trials of new diagnostic tests, vaccines, and therapies for a wide variety of STD pathogens; and directed an internationally recognized reference laboratory for STD pathogens (Neisseria gonorrhoeae, Chlamydia trachomatis, and syphilis). He has served as a consultant and committee member for a number of national and international organizations including the National Academies of Sciences, Engineering, and Medicine, National Institutes of Health, Centers for Disease Control and Prevention, and World Health Organization. Before joining the University of Alabama at Birmingham, he worked at Johns Hopkins University and with the Baltimore City Health Department. He earned his M.D. from Cornell University.

Patricia Kissinger

Patricia Kissinger, B.S.N., Ph.D., M.P.H., is professor at Tulane University and an infectious disease epidemiologist. She has worked both nationally and internationally for more than three decades in the field of HIV, sexually transmitted diseases, and women’s reproductive health in Africa, Haiti, and the United States. Dr. Kissinger focuses on the dynamics of STD/HIV transmission, particularly among vulnerable populations, examining issues of HIV/STD partner notification, expedited partner treatment, sexual networks, substance abuse, pregnancy prevention, and repeat STDs. The ultimate goal of her research is to reduce STD-related health disparities. She has been the Principal Investigator on dozens of federally funded research grants and has published over 160 manuscripts and numerous book chapters. Dr. Kissinger is a frequent reviewer for the National Institutes of Health, an expert consultant for the Centers for Disease Control and Prevention, and is an Associate Editor of the journal Sexually Transmitted Diseases. She earned her B.S.N. from Marquette University and her M.P.H. and Ph.D. from Tulane University.

Guillermo Prado

Guillermo J. Prado, Ph.D., is Dean of the University of Miami Graduate School. He is also the Leonard M. Miller Professor of Public Health Sciences and the director of the Division of Prevention Science and Community Health at the Miller School of Medicine. Dr. Prado’s research focuses on developing, evaluating, and translating preventive interventions for addressing smoking, alcohol, drug abuse, HIV/STDs, and obesity health disparities among Hispanic youth. His research has been recognized by professional organizations such as the Society for Prevention Research, the National Hispanic Science Network on Drug Abuse, and the Society for Research on Adolescence. He is currently a Board Member of Research!America and President of the Society for Prevention Research. Dr. Prado earned his Ph.D. from the University of Miami.

Cornelis Rietmeijer

Cornelis (“Kees”) Rietmeijer, M.D., Ph.D., M.S.P.H., is an independent STI consultant. His expertise is in the areas of STI clinical operations and workforce development. He is a professor of Community and Behavioral Health at the Colorado School of Public Health, University of Colorado Denver. He is the director of the North American Region of the International Union Against Sexually Transmitted Infections and an associate editor of the journal Sexually Transmitted Diseases. Until his retirement in 2009, he was the director of the STD control program and clinic at the Denver Public Health department and the Denver STD Prevention Training Center. He is a past president of the American Sexually Transmitted Diseases Association. Between 2009 and 2016, Dr. Rietmeijer worked and traveled extensively in southern Africa where he was the course director of an HIV/STI prevention course for the Southern African Prevention Initiative and the principal investigator of an STI etiology study in Zimbabwe. Dr. Rietmeijer earned his M.D. and Ph.D. degrees from the University of Amsterdam and his M.S.P.H. from the University of Colorado Denver.

Alina Salganicoff

Alina Salganicoff, Ph.D., is Senior Vice President and Director of Women’s Health Policy at the Kaiser Family Foundation. Widely regarded as an expert on women’s health policy, she has written and lectured extensively on health care access and financing for low-income women and children. Her work at Kaiser Family Foundation focuses on health coverage and access to care for women, with an emphasis on challenges facing underserved women throughout their lifespan. Dr. Salganicoff was also an associate director of the Kaiser Commission on Medicaid and the Uninsured and worked on the health program staff of the Pew Charitable Trusts. She has served on numerous federal, state, and non-profit advisory committees focusing on improving the quality of and access to health care for women, including for the Department of Health and Human Services Office on Women’s Health, Agency for Healthcare Research and Quality, Health Resources and Services Administration, Centers for Disease Control and Prevention, Department of Veterans Affairs, and the National Academies of Sciences, Engineering, and Medicine. Currently she is a member of the advisory panel of the American College of Obstetricians and Gynecologists’ Women’s Preventive Services Initiative, the public policy advisory committee of Power to Decide, and the advisory board of the Hope and Grace Fund. Dr. Salganicoff holds a Ph.D. from Johns Hopkins University.

John Schneider

John Schneider, M.D., M.P.H., is a professor of medicine and epidemiology and a network epidemiologist and infectious disease specialist in the Departments of Medicine and Public Health Sciences at the University of Chicago. He is also Director of the University of Chicago Center for HIV Elimination, where he works on developing getting to zero strategies informed by computational modeling both domestically and internationally. Dr. Schneider’s research focuses on how social networks can be leveraged to improve the health of community members vulnerable to HIV and other STIs in resource-restricted settings. In these settings he also implements network interventions guided by data and community input to eliminate new HIV transmission events. Clinically, he specializes in HIV primary care, HIV/STI prevention, and gender-affirming care and has a specific interest in the provision of high-quality care to sexual and gender minority community members of color. Dr. Schneider has extensive experience with advancing the physician-patient relationship in resource-restricted settings, including in his current clinic at Howard Brown Health 55th Street, a leading Federally Qualified Health Center on the South Side of Chicago, and during his time working in South India. Dr. Schneider received his M.D. and M.P.H. from Tufts University.

Neeraj Sood

Neeraj Sood, Ph.D., is professor and vice dean for faculty affairs and research at the University of Southern California (USC) Sol Price School of Public Policy and a founding member the USC Schaeffer Center. He is also a research associate at the National Bureau of Economic Research. Dr. Sood’s research focuses on economic epidemiology, pharmaceutical markets, health insurance, economics of innovation, Medicare, and global health. He has published over 100 papers in peer-reviewed journals in economics, medicine, and policy. Dr. Sood has testified frequently on health policy issues and has been on expert committees for the National Academies of Science, Engineering, and Medicine. His work has been featured in media outlets including The New York Times, The Washington Post, U.S. News and World Report, and Scientific American. Dr. Sood was the finalist for the 16th and 21st annual National Institute for Health Care Management Health Care Research Award, recognizing outstanding research in health policy. He was awarded the Eugene Garfield Economic Impact Prize, which recognizes outstanding research demonstrating how medical research impacts the economy. Dr. Sood is a board member of the American Society of Health Economists. Prior to joining USC, he was a senior economist at RAND and a professor at the Pardee RAND Graduate School, where he also received his Ph.D.

Jessica Willoughby

Jessica Willoughby, Ph.D., is an assistant professor at the Edward R. Murrow College of Communication at Washington State University. Her research focuses on health communication strategies with an emphasis on adolescents and mobile technologies. Her recent work has focused on adolescents’ use of technology for sexual health information, specifically examining the North Carolina BrdsNBz sexual health text message service. Dr. Willoughby previously worked as a research health analyst contracting with the Center for Communication Science at RTI International. She earned her Ph.D. from the University of North Carolina at Chapel Hill.

Sean D. Young

Sean D. Young, Ph.D., M.S., is an associate professor in the Departments of Emergency Medicine and Informatics at the University of California, Irvine. He is also the Executive Director of the University of California Institute for Prediction Technology, which studies how social big data (e.g., social media, wearable devices, and online search) and machine learning/data mining can be used to predict real-world events such as disease outbreaks. Trained as a behavioral psychologist, Dr. Young’s research focuses on two main areas: 1) using social “big data” to monitor and predict public health issues such as HIV, drug addiction, and crime, and 2) designing and testing technologies to address public health and medical issues among at-risk populations, including African Americans, Latinos, and men who have sex with men. Dr. Young previously worked on the faculty at the School of Medicine at the University of California, Los Angeles, and at the NASA Ames Research Center. He received his Ph.D. from Stanford University.

Carmen D. Zorrilla

Carmen D. Zorrilla, M.D., is a professor of obstetrics and gynecology at the University of Puerto Rico School of Medicine. She is also the principal investigator of the University of Puerto Rico clinical trials unit, which includes adult and pediatric AIDS trials. Certified by the American Board of Obstetrics and Gynecology and the American Academy of HIV Medicine, Dr. Zorrilla has experience in both obstetrics and gynecology and HIV-related research. This work includes behavioral interventions and clinical trials with HIV-infected and at-risk populations, as well as with pregnant and non-pregnant women. Dr. Zorrilla has participated in diverse clinical and behavioral research projects for women living with HIV. In 1987, she established the first longitudinal clinic for women living with HIV in Puerto Rico and was instrumental in making AZT available to pregnant women living with HIV in Puerto Rico. Her clinic, in which more than 600 infants have been born to HIV-positive women, has had a nearly zero transmission rate during the past 16 years. Dr. Zorrilla also implemented the first group prenatal care program in Puerto Rico; this new model of care evidenced a reduction in preterm births and infant low-birth weights. She is also one of the leaders who spearheaded the research response to the emerging Zika epidemic among pregnant women in Puerto Rico, and she helped establish a multidisciplinary clinic for these women. Dr. Zorrilla is also evaluating the impact of Hurricane Maria on mothers and infants; her team developed a hurricane preparedness session for pregnant women during group care. Dr. Zorrilla has been a consultant for national and international organizations including the National Institutes of Health, the Maternal and Child Health Bureau, the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the Institute for Healthcare Improvement. She is also a former member of the Office of Women’s Health Advisory Committee and the CDC/HRSA AIDS and STD Advisory Committee, and is currently a member of the National Advisory Council on Minority Health and Health Disparities. Dr. Zorrilla earned her M.D. from the University of Puerto Rico School of Medicine.

Meeting

Prevention and Control of Sexually Transmitted Infections in the United States: September 14 Public Input Meeting

September 14, 2020

3:00 PM - 5:00 PM (ET)

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About

The Committee on Prevention and Control of Sexually Transmitted Infections in the United States will hold two virtual information-gathering meetings in September to hear from individuals about their experiences with issues related to STIs. These discussions will include the perspectives of persons in communities that are often marginalized and whose voices are sometimes missing when dealing with serious national problems such as STIs. The meetings will take place:

September 9, 1:00pm – 3:00pm ET
September 14, 3:00pm – 5:00pm ET

Registration is mandatory for this meeting. Please email STIPrevention@nas.edu with your name and affiliation to register, or for more information.

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Is it a Closed Session event?

Not Closed

Contact

Harika Dyer

STIPrevention@nas.edu

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Prevention and Control of Sexually Transmitted Infections in the United States

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Sexually Transmitted Infections: Adopting a Sexual Health Paradigm

Description

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Major units and sub-units

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Health Care Financing to Improve Availability of Affordable Contraception: Identifying Promising Practices

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