A LANDMARK new analysis highlights how rapid advances in biomedical prevention, diagnostics, and service-delivery models are transforming the global response to HIV and sexually transmitted infections (STIs). The authors report that innovation across antivirals, vaccines, point-of-care testing, and integrated care pathways is beginning to close long-standing gaps in STI control, while warning that fragmented services and uneven access still threaten progress toward the 2030 international targets.
Despite major gains in HIV treatment and prevention, particularly the widespread impact of the “undetectable = untransmittable” paradigm, progress against other STIs has lagged. The authors highlight that biological interactions between HIV and STIs, where untreated STIs increase HIV susceptibility and infectiousness, make a siloed approach increasingly inadequate.
Expanding Options in Biomedical Prevention
The review describes an expanding prevention toolbox, including daily oral pre-exposure prophylaxis(PrEP), event-driven PrEP, and long-acting agents, which offer durable protection and address challenges with adherence. For bacterial STIs, doxycycline post-exposure prophylaxis shows promise, though concerns about antimicrobial resistance remain substantial.
Next-Generation Diagnostics Accelerate STI Detection
Rapid diagnostic innovations, such as molecular point-of-care assays and improved lateral-flow tests, are improving early detection of HIV, syphilis, gonorrhoea, and chlamydia. However, the authors caution that implementation gaps persist, especially in low-resource settings where results must be rapid, affordable, and actionable.
Toward Integrated, Person-Centred Services
The paper emphasises the value of combined HIV/STI clinics, differentiated care models, and community-based service delivery to reduce stigma and expand access. Multipurpose prevention technologies, such as products that simultaneously prevent HIV, STIs, and unintended pregnancy, represent an important frontier for future programmes.
By drawing lessons from decades of HIV progress, the authors argue that integrated strategies are essential to revitalise global STI control and to ensure equitable access to prevention and care.
Reference
Peters RPH et al. Innovations in the biomedical prevention, diagnosis, and service delivery of HIV and other sexually transmitted infections. The Lancet. 2025;DOI:10.1016/S0140-6736(25)00983-3.
