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Review
. 2021 Jan 12;6(1):264-273.
doi: 10.1093/jalm/jfaa163.

Laboratory Perspective on Racial Disparities in Sexually Transmitted Infections

Joshua A Lieberman  1 , Chase A Cannon  2 , Lori A Bourassa  1
Affiliations
Review

Laboratory Perspective on Racial Disparities in Sexually Transmitted Infections

Joshua A Lieberman et al. J Appl Lab Med. .

Abstract

Background: Rates of sexually transmitted infections (STI) have risen steadily in recent years, and racial and ethnic minorities have borne the disproportionate burden of STI increases in the United States. Historical inequities and social determinants of health are significant contributors to observed disparities and affect access to diagnostic testing for STI.

Content: Public health systems rely heavily on laboratory medicine professionals for diagnosis and reporting of STI. Therefore, it is imperative that clinicians and laboratory professionals be familiar with issues underlying disparities in STI incidence and barriers to reliable diagnostic testing. In this mini-review, we will summarize contributors to racial/ethnic disparity in STI, highlight current epidemiologic trends for gonorrhea, chlamydia, and syphilis, discuss policy issues that affect laboratory and public health funding, and identify specific analytic challenges for diagnostic laboratories.

Summary: Racial and ethnic disparities in STI in the US are striking and are due to complex interactions of myriad social determinants of health. Budgetary cuts for laboratory and public health services and competition for resources during the COVID-19 pandemic are major challenges. Laboratory professionals must be aware of these underlying issues and work to maximize efforts to ensure equitable access to diagnostic STI testing for all persons, particularly those most disproportionately burdened by STI.

Keywords: Health disparities; chlamydia; gonorrhea; sexually transmitted; syphilis.

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Figures

Fig. 1
Fig. 1
Incidence of chlamydia, gonorrhea, and primary and secondary syphilis in the United States for 2018. Gray solid bars represent overall reported cases per 100 000, which includes cases where sex was not reported. Green solid bars represent cases in female patients, and blue checkered bars represent cases in males. Separate panels for chlamydia (A), gonorrhea (B), and primary and secondary syphilis (C). Data from Centers for Disease Control and Prevention, Sexually Transmitted Disease Surveillance Report, 2018.
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