Summary
Point-of-care (POC) testing for sexually transmitted infections (STIs) is crucial for combating the rising STI rates, particularly among marginalized groups. The current laboratory-based testing model, with its delays and barriers to access, fuels inequalities and hinders timely diagnosis and treatment. Widespread implementation of POC STI testing, integrated into services for affected populations, can provide immediate diagnosis and treatment, empowering patients and improving public health outcomes.
Charna Albert
April 2026—In quite a few areas of medicine, testing at the point of care has become the norm—or at least available, accessible, and, in some cases, inexpensive.
Not so with sexually transmitted infection.
“STIs continue to be in this different realm,” said Aniruddha Hazra, MD, in an ADLM session last summer on eliminating inequities in STIs using point-of-care testing. For Dr. Hazra, associate professor in the section of infectious diseases and global health at the University of Chicago and director of the Sexual Wellness Clinic at UChicago Medicine, point-of-care testing offers patient-centered solutions for combating the STI epidemic, particularly among the groups that are marginalized and most affected. At the same time, he emphasized in his session that point-of-care STI screening is not a “one-size-fits-all strategy.”
Reported cases of chlamydia, gonorrhea, and syphilis have risen over the past two decades, Dr. Hazra said. And although STI diagnostic rates have increased across all U.S. populations, certain groups—young people, women, LGBTQ+ people, Blacks, Hispanics, Latinos, and American Indian/Alaska natives—are disproportionately affected. “For example, people ages 15 to 24 make up 13 percent of the population but account for 22 percent of syphilis cases, 42 percent of gonorrhea cases, and 62 percent of chlamydia cases overall,” Dr. Hazra said. “Clearly, this is a population we would want to prioritize when thinking about new or novel advancement in the STI testing landscape.”
STI-related medical expenditures in the U.S. are approaching $16 billion a year. The Centers for Disease Control and Prevention in 2018 estimated that STIs impose a nearly $2 billion lifetime direct medical cost, a number that has only been compounded post-COVID. “Clearly there’s a cost-benefit to interrupting disease transmission through novel testing means,” he said.
To add to the problem, the CDC’s annual STI prevention budget has remained flat for the past two decades. “When you account for inflation as well as population [growth], we’ve gone down by about 50 percent purchasing power,” Dr. Hazra said. Over those two decades, syphilis cases rose from 7,177 in 2003 (https://bit.ly/3MFAd1B) to 209,253 in 2023. “This is not rocket science,” he said. “As we are divesting progressively from STD prevention, we will see increases in STDs that will impact the most vulnerable communities first.” Syphilis is a case in point. “Over the past 20 years, syphilis, which we were on the verge of eradicating at the turn of the millennium, has disproportionately and exponentially increased in all populations.”
There’s some good news in the CDC’s provisional 2024 STI surveillance data, its most recent. (The final report will be released later this year.) A total of 1.5 million cases of chlamydia were reported in 2024, a decrease of four percent since 2020, and 543,409 cases of gonorrhea were reported, a 20 percent decrease since 2020. But 190,242 cases of syphilis were reported in 2024, a 42 percent increase since 2020. Most concerning, he said, 3,941 cases of syphilis among newborns were reported, an 82 percent increase since 2020 of congenital syphilis “and what we are most trying to prevent in the U.S.”