Alison Footman

Background: Chlamydia infection rates are high among young adults (YA, ages 18-24). Fortunately, vaccines are being developed to target this pathogen, but chlamydia vaccine acceptability has remained largely unaddressed. The purpose of this descriptive study was to assess the acceptability of a prospective chlamydia vaccine and perceived barriers to receiving such a vaccine among YA. Methods: Sexually active YAs in the United States were recruited for an online survey in May 2022. Participants were asked to indicate their likelihood of being vaccinated for chlamydia, receiving the vaccine if recommended by a doctor, researching the vaccine, and asking their provider about the vaccine (5-point Likert scale). Barriers were listed and participants indicated if each barrier would discourage them. Demographic information was collected, and descriptive analyses were conducted in SAS. Results: Approximately 49% of participants were likely to get a chlamydia vaccine (184/379); this increased to 56% if the vaccine was recommended by a physician (211/379). Only 14% were likely to ask their provider about a chlamydia vaccine (42/295) and 16% were likely to seek additional information about the vaccine (50/320). Barriers with a strong influence included vaccine effectiveness (72%, 273/379), cost (68%, 256/379), and for contracting chlamydia because of the vaccine (66%, 251/379). Discussion: Nearly half of YA are accepting of a chlamydia vaccine, with physician influence likely to increase acceptance. Before implementation, studies should identify effective strategies to educate physicians about their role in vaccine uptake and inform the general population on the safety and effectiveness of the chlamydia vaccine.

Introduction: Syndromic management remains the primary approach for identifying and treating sexually transmitted infections (STIs) in low-resource settings. While faster and inexpensive, it leads to overtreatment, undertreatment and missed opportunities for surveillance. Recent advances in point-of-care (POC) diagnostic technologies for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other STIs present new opportunities to improve STI management. Methods: In September 2024, the Gates Foundation convened a 3-day expert meeting in Nairobi, Kenya, bringing together 44 global and national experts in STI diagnostic development, implementation research, policy, regulatory affairs and clinical practice. The objective was to identify priorities and strategies for advancing the introduction and scale-up of STI POC testing in low-resource settings with a focus on sub-Saharan Africa. Results: Participants identified opportunities and barriers for introducing STI POC testing at various levels: individual client, health service delivery, national and global. At the individual client level, recommendations to optimise testing uptake included identifying and piloting strategies to improve knowledge about STIs and testing as well as addressing barriers to testing. At the health service delivery level, recommendations were to optimise clinical workflows, consider testing outside traditional health facilities (including private pharmacies), encourage self-collection and improve partner notification. At the national level, recommendations included updating treatment guidelines to incorporate diagnostic testing, strengthening laboratory quality assurance for STI tests and advocating for the public health importance of STIs, which remain underprioritised. This also involves building political commitment. At the global level, recommendations included harmonising regulatory requirements across regions, leveraging WHO prequalification processes, and expanding manufacturing capacity through technology transfer. Conclusions: Effective introduction of STI POC diagnostics in low-resource settings will require coordinated efforts across global and national levels. Successful introduction, while ensuring equitable access, will accelerate access to quality STI care, reduce antimicrobial resistance and improve STI control outcomes.

Objectives: The demand for point-of-care testing (POCT) increased exponentially during the COVID-19 pandemic, providing a convenient and accessible method of virus detection outside of traditional laboratory settings. As high rates of sexually transmitted infections (STIs) remain a prominent public health concern, POCT for STI detection may offer an option that reduces key barriers to care such as stigma and limited clinic hours. The aim of this narrative review is to identify key facilitators, barriers and gaps related to the acceptability and implementation of STI POCT from patient perspectives in non-traditional settings. Methods: To conduct this narrative review, a comprehensive literature search was conducted using PubMed, Embase and Scopus to identify relevant studies published between 1 January 2015 and May 2025, focusing on patient perspectives and contextual determinants of POCT implementation for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). Search terms included free-text keywords (such as “point of care”) and indexed terms (such as Point-of-Care Testing (MeSH)). Findings were contextualised based on patient perspective data and implementation into non-traditional settings. Results: 40 studies were included in the narrative review, reflecting geographical regions where POCT implementation has been prioritised. Study designs and implementation environments varied. POCT for CT/NG screening generally reported high diagnostic accuracy and reliability as well as increased uptake and high acceptability across settings. Availability, perceived convenience and increased autonomy significantly influenced POCT uptake and implementation among patients. Implementation facilitators included ease of device usage, minimal training and improved quality of care. Implementation barriers primarily focused on logistics, workflow and cost. Conclusions: Community-engaged approaches to designing and implementing STI POC tests in non-traditional settings are necessary to better understand specific needs. High patient satisfaction, device acceptability and improved health outcomes place STI POCT as a promising avenue for strengthening public health efforts against the STI epidemic.

Purpose of review: Development of vaccines that protect against sexually transmitted infections (STIs), including for chlamydia, gonorrhea, and syphilis, has progressed greatly over the past decade. However, little research has been conducted to examine STI vaccine acceptance and hesitancy and how these factors may impact future uptake. This review examines literature that could provide additional insights into factors that would impact STI vaccine acceptance and hesitancy. Recent findings: Vaccine hesitancy remains a threat to the uptake of future STI vaccines despite recent findings that highlight high levels of acceptability. Vaccine characteristics including side effects postvaccination and cost could impact future uptake of these vaccines. Accurate information about the benefits of vaccination and the vaccine development process could help to improve vaccine acceptance. Summary: STI vaccine development is progressing, leading to great promise that a chlamydia, gonorrhea, or syphilis vaccine will one day be available. However, data is limited on factors that could impact vaccine acceptance, hesitancy, and uptake. This research is instrumental in creating policies, programming and vaccination campaigns that could impact acceptance and uptake along with affordability and accessibility. Additional research is needed to better promote STI vaccines.

Trujillo and colleagues present an interesting study about STI testing disparities among trans women in California and the need for comprehensive sexual health services. This is one of few studies to report on STI testing and needs among trans women in the United States and identifies gaps in current sexual health programs. The authors found that HIV testing were higher than STI testing rates, highlighting the need for improved STI screening efforts, especially for sexual and gender minorities.

Background: Chlamydia vaccines are currently under development and have the potential to lower the incidence of infection and disease, which are highest among adolescents and young adults. Ideally, a chlamydia vaccine would be administered to adolescents before sexual debut, a time when parents are the primary vaccine decision makers. This study explores parent opinions about an adolescent chlamydia vaccine to understand barriers and facilitators to uptake. Methods: Semistructured interviews were conducted with parents of adolescents. Topics included conversations parents have with their children about chlamydia, opinions on chlamydia vaccine development, and vaccine characteristics, such as efficacy and cost. Interviews were analyzed using a thematic analysis approach. Results: From March to April 2021, 21 interviews were completed. Few parents discuss chlamydia with their children and sex education was seen as limited. Overall, 16 parents indicated that a chlamydia vaccine is needed. However, there were mixed opinions about vaccinating their own children, related to the need to vaccinate at a young age, vaccine efficacy, and confusion about benefits of vaccination. Finally, healthcare provider recommendations were seen as important before deciding to vaccinate a child. Conclusions: Although parents think that chlamydia vaccines are needed, lack of awareness about infections and potential benefits of vaccination could serve as barriers to uptake. Healthcare provider recommendations can help to improve knowledge and vaccine uptake. However, there is a need for multilevel approaches to improve chlamydia awareness and ensure that vaccination initiation and completion rates remain high.

In this paper, we describe: (a) our experiences and accomplishments in the American Academy of Health Behavior (AAHB) Research Scholars Mentoring Program; (b) the current state of mentorship in the field of sexually transmitted infections (STIs); (c) the fundamental factors of successful mentoring, including alignment with personal values, transparency, intentionality, respect, equity, empathy, and emotional intelligence. The authors have reviewed their experiences in mentoring and receiving mentorship and have collectively identified concepts they valued in mentoring relationships, particularly those that are useful for women in science. The authors provide recommendations and considerations for future mentoring relationships.