Global Burden of Sexually Transmitted Infections in Women of Reproductive Age, 1990-2021: Global, Regional, and National Estimates From the Global Burden of Disease 2021.

BACKGROUND

Sexually transmitted infections, excluding HIV, continue to pose a major global public health burden, particularly amongst women of reproductive age. Despite strengthened global interventions, the distribution and trends of sexually transmitted infections vary significantly across regions and levels of the Socio-Demographic Index.

METHODS

We analysed data from the Global Burden of Disease Study 2021 to assess the burden of sexually transmitted infections in 204 countries and territories from 1990 to 2021. Indicators included incidence, prevalence, mortality, and disability-adjusted life years, stratified by age, sex, and Socio-Demographic Index levels. Bayesian meta-regression was used to estimate the average annual percentage change for each indicator.

RESULTS

Amongst women aged 15-49, the global sexually transmitted infections incidence rate increased from 13,847.22 to 14,701.69 per 100,000 person-years between 1990 and 2021 (average annual percentage change = 33.35, p < 0.001). Incidence rose for Chlamydial infection (average annual percentage change = 11.10), Genital herpes (average annual percentage change = 1.11), and Trichomoniasis (average annual percentage change = 34.76), but it declined for Gonococcal infection (average annual percentage change = -11.73). All burden indicators were negatively correlated with the Socio-Demographic Index (incidence: r = -0.541; disability-adjusted life years: r = -0.613; p < 0.001 for all). From 2022 to 2035, projections suggest a decrease in Chlamydial and Gonococcal infections, and a continued increase in Genital herpes and Trichomoniasis.

CONCLUSION

Sexually transmitted infections remain a pressing global issue for women of reproductive age, particularly in low- and middle-Socio-Demographic Index regions such as East Asia, sub-Saharan Africa, and Latin America. Enhanced sexual health education, broader access to care, and stronger surveillance systems are critical for reducing this burden.