What Is the STI National Strategic Plan?
The Sexually Transmitted Infections National Strategic Plan (STI Plan) (1.8 MB) is a groundbreaking, first-ever, five-year plan that
aims to reverse the recent dramatic rise in STIs in the United States. The STI Plan sets a vision as well as goals, objectives, and strategies to respond to this STI epidemic. It also includes indicators with measurable targets to track progress.
The STI Plan aims to provide a roadmap for a broad range of stakeholders—including public health, health care, government, community-based organizations, educational institutions, researchers, private industry, and academia—to develop, enhance and expand STI prevention and care programs at the local, state, tribal and national levels over the next five years.
Why do we need an STI National Strategic Plan?
The STI epidemic affects the health of people and communities and is costly to the health care system. When left untreated, STIs can lead to long term health problems such as chronic pelvic pain, infertility, and poor birth outcomes including death of newborns. STIs can also increase the risk of getting HIV and giving HIV to others. Additionally, human papillomavirus (HPV) infection causes about 35,000 cases of cancer each year, even though there is a safe and highly effective vaccine that prevents the cancer-causing strains of HPV. STIs affect the quality of life for millions of Americans and cost the health care system billions of dollars annually.
STI rates have risen dramatically. From 2014–2018, the rates of reported cases of primary and secondary syphilis, congenital syphilis, gonorrhea, and chlamydia rose 71%, 185%, 63%, and 19%, respectively. HPV, the most common STI, accounts for 14 million new infections each year.
The impact of the STI epidemic does not fall equally across all populations and regions. Adolescents and young adults, men who have sex with men, and pregnant women are disproportionately impacted by STIs. Social determinants of health contribute to an unequal burden of STIs in Black, American Indian/Alaska Native and Hispanic communities. In addition, people living in the Southern and Western regions of the U.S. are disproportionately affected.
STI National Strategic Plan
The United States will be a place where sexually transmitted infections are prevented and where every person has high-quality STI prevention, care, and treatment while living free from stigma and discrimination.
This vision includes all people, regardless of age, sex, gender identity, sexual orientation, race, ethnicity, religion, disability, geographic location, or socioeconomic circumstance.
The STI Plan has five high-level goals:
- Prevent new STIs.
- Improve the health of people by reducing adverse (harmful) outcomes of STIs.
- Accelerate progress in STI research, technology, and innovation.
- Reduce STI-related health disparities and health inequities.
- Achieve integrated, coordinated efforts that address the STI epidemic.
Each of the goals has a set of objectives and strategies to help steer federal partners and other stakeholders toward achieving them. The objectives and strategies are evidence- and science-based, flexible, integrated, and promote innovative approaches.
The Plan’s goals, objectives, and strategies apply equally to most STIs, although it highlights four of the STIs that have the greatest impact on the health of the nation: chlamydia, gonorrhea, syphilis, and HPV. It also identifies populations and geographic regions that experience the highest burden of STIs based on nationwide data so that federal agencies and other stakeholders can focus their resources to have the greatest impact. Stakeholders are encouraged to use the data for the jurisdiction or population(s) they serve to identify where their resources may have the greatest impact.
The STI Plan is designed to meet the prevention and treatment needs of everyone in the United States—but the plan recognizes that some groups of people and some communities and regions are more impacted by STIs than others. These specific groups are called “priority populations.” Based on national level data, they are:
- Adolescents and young adults
- Men who have sex with men (MSM)
- Pregnant women
Within these populations, the plan also notes that certain racial and ethnic minority communities (Black, American Indian/Alaska Native, and Hispanic) and geographic regions (Southern and Western regions of the United States) are more impacted by STIs than others.
Other Key Elements of the STI Plan
The STI Plan strongly emphasizes the need to address stigma, discrimination, and social determinants of health in order to reverse the rise in STI rates. Another theme interwoven in the STI Plan is the need to integrate STI prevention and control into other public health efforts to prevent and treat HIV, viral hepatitis, and substance use disorders.
The plan notes that we can improve and sustain people’s health and reduce health inequities by working to establish policies and programs that improve the conditions in which we live, learn, work, and play. These actions will ultimately create a healthier population and society.
The STI Plan identifies indicator measures and sets targets for each indicator. These will be used to track progress toward achieving the plan’s goals. There are seven core indicators to measure progress for the entire plan. Some core indicators are also used to measure progress in addressing disparities in STIs among the priority populations and subpopulations (i.e., disparities indicators). The STI Plan also offers recommendations for developing additional indicators to improve our nation’s ability to measure progress in reducing STIs.
For each core and disparities indicator, the STI Plan begins with a baseline measurement and establishes annual quantitative targets through 2030 because STIs will continue to pose a threat to the public’s health past 2025. The indicators use existing national data sources that:
- Generate data regularly and consistently, making it possible to do nationwide, cross-year comparisons; and
- Allow for breaking down the information by age, geographic region, race, ethnicity, and sex, and, when available, sex of sex partners.
Next steps: Federal STI Implementation Plan
Federal partners will collaborate to develop an implementation plan that supports the STI Plan’s goals and suggested action steps. This Federal Implementation Plan will spell out federal partners’ specific commitments to developing policies, initiatives, and activities to meet the goals of the STI Plan. HHS will publish this implementation plan to ensure transparency and accountability.
As part of their ongoing commitment to reduce STIs in the U.S., federal partners have committed to serve on an STI Plan implementation working group. This group will meet regularly to coordinate activities across agencies and Departments, monitor progress toward the indicator targets, implement lessons learned from data and research findings, change course when necessary, and report on national progress.