Dear Advocate,
As 2025 draws to a close, the STI field is at a pivotal moment, facing rising infections, decreased funding, and a strained global health landscape. Yet there is real promise in new innovations to effectively test for and ultimately treat and prevent new infections.
This year, AVAC and partners focused on providing the evidence and tools needed to push for smarter investments and equitable access to STI prevention and diagnostics. Read on for key developments from 2025 and issues to watch in 2026.
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Growing STI Burden Meets Slow Policy Change
Syphilis, congenital syphilis, gonorrhea (including drug-resistant strains), and chlamydia rates continued to rise globally in 2025. Despite widespread recognition, too many countries remained locked into syndromic management approaches that may miss asymptomatic infections, especially among women, adolescents, and LGBTQ+ communities. See the WHO’s July guidelines for the management of asymptomatic sexually transmitted infections.
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HPV Vaccination Breakthrough Demonstrates the Power of STI Prevention
In 2025, Gavi, the Vaccine Alliance and partners announced a landmark achievement: 86 million girls vaccinated against HPV in lower-income countries, averting an estimated 1.4 million deaths—meeting a global target ahead of schedule. This milestone illustrates the immense power of STI vaccines as a cornerstone of prevention.
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Expanding Momentum for STI Advocacy Across Africa
Throughout 2025, civil society partners across East and Southern Africa advanced national dialogues, policy landscaping, convenings, and resources that reframed STIs as issues of equity, rights, and public health integration. Community voices continued to shape the STI prevention agenda to drive demand for diagnostics, identify structural barriers, and begin to advocate with national governments to update testing and treatment guidelines. Read more.
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New Diagnostics on the Horizon—But Too Slowly and Too Unevenly
2025 saw meaningful progress in the development of point-of-care tests, that could make routine STI testing more feasible. But as we highlighted in our September STI Watch newsletter, these technologies are still emerging far too slowly, and without sufficient financing, procurement planning, or policy alignment to support equitable rollout.
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Rise of Self-Care & User-Controlled Options
From syphilis and HIV self-testing to self-collection of samples for chlamydia, gonorrhea, and HPV, 2025 marked a turning point in showcasing self-care as a powerful, rights-based, user-centered approach for STI prevention and sexual and reproductive health. Yet major gaps remain in national policies, provider training, and procurement systems. See AVAC’s guide to Self-Care Advocacy for HIV and STI Prevention.
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| What We’re Watching in 2026 |
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Self-Care as a Core Strategy
Self-care is no longer an experimental concept; it’s essential. In 2026, we will continue tracking whether governments:
- Adopt and fund national self-care policies;
- Integrate self-collection and self-testing within primary care and SRH platforms;
- Ensure user-centered options are affordable and widely available.
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Diagnostics Are Coming, But Not Fast or Equitable Enough
New molecular tests continue to emerge for the detection of gonorrhea, chlamydia, syphilis, HPV, and trichomoniasis. But without political will and coordinated financing, they will remain out of reach. In 2026, we’ll monitor:
- Whether countries update testing and screening guidelines;
- Alignment of global and national investments with diagnostic priorities;
- Progress toward moving beyond symptom-driven care;
- Efforts to ensure affordability and equitable access.
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Moving Beyond Syndromic Management
Syndromic management fails to identify most STIs, especially asymptomatic ones. We will continue building the evidence and advocacy necessary to push governments toward diagnostic-led strategies that find infections early. In 2026 we’ll track:
- National guideline revisions;
- Budget and procurement changes;
- Implementation challenges and opportunities.
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STI Vaccine R&D Is Advancing—but Equity Remains at Risk
Scientific progress is accelerating for STI vaccine development—particularly for gonorrhea, and group B meningococcal vaccines—but in other areas, progress is slow, fragmented and underfunded. In 2026, we will follow:
- Investment levels in STI vaccine research and development;
- Progress in the pipeline;
- Whether there is investment to build equity, community input, and Good Participatory Practice (GPP) into R&D and rollout plans.
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Despite challenges in global health financing and political instability, the STI field is entering 2026 with renewed momentum. With affordable diagnostics, routine testing, new preventive vaccines under development, user-centered options, and sustained investment, the trajectory of the STI epidemic can be changed.
We will continue to track the research and developments, share the needs and insights from communities, and provide resources to ensure a more equitable future for STI prevention.
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