A Clinical Perspective on Sexually Transmitted Infections: What is the State of Play

Sexually transmitted infections (STIs) continue to affect most sexually active populations across the globe, especially the traditional high-risk groups for bacterial STIs such as young people, men who have sex with men (MSM) and individuals from black and minority ethnic populations. Bacterial STIs such as Gonorrhoea and Chlamydia remain common. In western settings, we have observed the re-emergence of high rates of syphilis and lymphogranuloma venereum, mostly in MSM. Urethral and vaginal discharge syndromes, genital ulcer disease are frequent clinical presentations. However, the development of highly sensitive molecular assays has revealed that asymptomatic infections are also common, particularly at extragenital sites, and probably drive transmission of STIs.