Introduction: Advancing Health and Equality Through New STI Guidelines

A report on the updated guidelines for the diagnosis and treatment of Sexually Transmitted Infections (STIs), presented at the 2025 Argentine Society of Infectious Diseases (SADI) Congress, reveals a significant step towards achieving key Sustainable Development Goals (SDGs). Developed by the HIV and STI Commission, these guidelines provide a comprehensive framework for sexual health that strongly aligns with SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities).

Aligning with Sustainable Development Goal 3: Good Health and Well-being

The primary focus of the new guidelines is to improve public health outcomes by addressing communicable diseases, directly contributing to SDG Target 3.3, which aims to end epidemics of communicable diseases, and Target 3.7, ensuring universal access to sexual and reproductive healthcare.

Comprehensive and Localized Health Strategies

The guidelines consist of 21 chapters covering a wide spectrum of STIs, including urethritis, syphilis, human papillomavirus, viral hepatitis, gonorrhea, and emerging threats like mpox. A critical aspect of this initiative is its departure from a one-size-fits-all approach. The content is specifically adapted to reflect local epidemiology, available diagnostic methods, and accessible treatments within the region, ensuring that health interventions are both relevant and effective in achieving SDG 3.

Enhancing Universal Access to Sexual Health Services

To promote universal health coverage (Target 3.8), the guidelines offer step-by-step recommendations for conducting a sexual history. This material is designed for accessibility, benefiting both specialist and primary care clinicians and thereby expanding the network of professionals equipped to provide competent sexual healthcare.

Fostering Inclusivity and Reducing Inequalities (SDG 5 & SDG 10)

A foundational principle of the guidelines is the creation of an inclusive, respectful, and stigma-free environment, which is essential for reducing health disparities and promoting equality as outlined in SDG 5 and SDG 10.

A Patient-Centered Approach to Eliminate Stigma

The guidelines emphasize that the initial patient interaction is critical for building trust and overcoming barriers to care. Clinicians are instructed to foster a comfortable environment through empathetic communication, active listening, and supportive body language before addressing sensitive topics. This approach directly combats the stigma and prejudice that often hinder access to care for marginalized groups, thereby advancing the goal of reducing inequalities.

Core Components for Equitable Sexual Health Consultations

The report outlines seven key areas for consideration during consultations to ensure a holistic and respectful assessment:

1. Reason for Consultation: Prioritizing the patient’s immediate concerns to guide the clinical process.
2. History of STIs: Assessing past infections and risk perception to inform current diagnostics and treatment, contributing to better health outcomes under SDG 3.
3. Sexual Partners: Inquiring respectfully about the number and gender of sexual partners without making assumptions about sexual orientation, upholding principles of non-discrimination central to SDG 10.
4. Sexual Practices: Gathering detailed information on potential exposure sites and practices to provide comprehensive and tailored care for all individuals.
5. STI Protection: Discussing preventative measures, including condom use and vaccination status for hepatitis A, hepatitis B, and HPV, which is a cornerstone of SDG 3.
6. Pregnancy Prevention: Integrating discussions on contraceptive use and reproductive planning, supporting SDG Target 5.6 on universal access to reproductive rights.
7. Other Sexual Health Issues: Creating space to screen for issues like sexual dysfunction and gender-based violence, offering referrals to specialized services and reinforcing the commitment to both gender equality (SDG 5) and overall well-being (SDG 3).

Strengthening Health Systems and Professional Capacity (SDG 4 & SDG 16)

The guidelines serve as a tool for building stronger, more inclusive health institutions (SDG 16) and underscore the need for continuous professional development (SDG 4).

Practical Recommendations for Priority Populations

To ensure no one is left behind, the guide provides specific recommendations for engaging with key populations who face a higher risk of STIs and systemic barriers to care. These groups include transgender people, sex workers, men who have sex with men, adolescents, incarcerated individuals, people who use drugs, and migrants. Recommendations include:

• Asking about self-identified gender and using gender-neutral language to respect individual identity (SDG 5, SDG 10).
• Delaying genital examinations until a level of trust is established to reduce patient anxiety.
• Recognizing and respecting that not all individuals are sexually active.
• Offering flexible services, such as evening clinic hours, to accommodate diverse patient needs.

The Imperative of Professional Training and Institutional Accountability

A central theme is the critical need for training the entire healthcare team to provide inclusive, stigma-free care. This aligns with SDG 4 (Quality Education) by promoting specialized knowledge and skills among health professionals. The report stresses that providers must be trained to address personal biases and must not become a barrier to care. By building the capacity of health systems to be responsive and accountable, these guidelines contribute to the development of strong institutions (SDG 16), ensuring that all individuals can exercise their right to health.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being

   • The article’s central theme is the presentation of updated guidelines for the diagnosis and treatment of sexually transmitted infections (STIs), which directly aligns with ensuring healthy lives and promoting well-being. It covers a wide range of diseases such as HIV, viral hepatitis, syphilis, and mpox, and emphasizes the importance of timely and appropriate care.

2. SDG 5: Gender Equality

   • The guidelines promote an inclusive and respectful environment, which is crucial for achieving gender equality. The article mentions the need to ask about self-identified gender, use gender-neutral language, screen for gender-based violence, and discuss access to safe abortion services. These points directly support the empowerment of all women, girls, and gender-diverse individuals.

3. SDG 10: Reduced Inequalities

   • The article highlights the need for stigma-free care for key populations and priority groups who are often marginalized and at a higher risk of STIs. These groups include “transgender people, sex workers, men who have sex with men, adolescents and young adults, incarcerated individuals, people who use drugs, and migrant populations.” By advocating for tailored, respectful, and accessible services for these groups, the guidelines aim to reduce health inequalities.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases. The article directly addresses this target by providing comprehensive guidelines for the diagnosis and treatment of a wide array of STIs, including HIV, viral hepatitis, syphilis, gonorrhea, and emerging infections like mpox.
   • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes. The guidelines explicitly cover sexual and reproductive health by including sections on pregnancy prevention, contraceptive use, and access to safe abortion services. The entire initiative is about educating healthcare professionals to provide these services effectively.
   • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. The article emphasizes making care accessible and preventing healthcare professionals from becoming a “barrier to care.” It also mentions assessing vaccination status for hepatitis A, hepatitis B, and HPV, which is a component of universal health coverage.

2. SDG 5: Gender Equality

   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences. The guidelines’ focus on patient interaction, privacy, consent, and providing information on contraception and safe abortion services directly supports this target.

3. SDG 10: Reduced Inequalities

   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status. The article’s specific recommendations for consulting with marginalized groups (transgender people, sex workers, migrants, etc.) and the call for training the entire healthcare team to provide “inclusive, stigma-free care” are direct actions toward this target.
   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard. The guidelines advocate for practices that ensure equal opportunity in healthcare access, such as avoiding assumptions about sexual orientation or gender identity and providing flexible services to accommodate different needs, thereby reducing inequalities in health outcomes.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicators for SDG 3

   • For Target 3.3: The article implies the use of Indicator 3.3.4 (Hepatitis B incidence per 100,000 population) and 3.3.1 (Number of new HIV infections per 1,000 uninfected population) by focusing on the diagnosis and treatment of these specific diseases. The mention of “local epidemiology” suggests that tracking the incidence of STIs like syphilis, gonorrhea, and mpox is a key measure of progress.
   • For Target 3.7: Progress can be measured by the number of healthcare professionals trained using these new guidelines. The article states the material “can benefit any healthcare professional in the region,” implying a goal of widespread training, which is a proxy for service capacity. Another implied indicator is the integration of comprehensive sexual history taking into primary care consultations.
   • For Target 3.8: An implied indicator is the accessibility of STI services for key populations. The recommendation for “flexible services to accommodate different needs” (e.g., evening clinic hours) suggests that service availability and patient uptake, especially among marginalized groups, are key metrics. Vaccination coverage for Hepatitis A/B and HPV (Indicator 3.b.1) is also explicitly mentioned as something to be assessed.

2. Indicators for SDG 5

   • For Target 5.6: The existence and implementation of the guidelines themselves serve as an indicator (related to 5.6.2: Number of countries with laws and regulations that guarantee full and equal access to women and men aged 15 years and older to sexual and reproductive health care, information and education). The article details how these guidelines are being put into practice in Argentina to ensure respectful and informed access to care.

3. Indicators for SDG 10

   • For Target 10.3: A relevant indicator is the proportion of the population reporting having personally felt discriminated against or harassed (Indicator 10.3.1). The article’s strong emphasis on creating a “respectful environment free from stigma, prejudice, or moral judgment” and training staff to address “personal biases” directly aims to reduce patient-reported experiences of discrimination in healthcare settings.

4. Table of SDGs, Targets, and Indicators

Source: medscape.com