Going public and making it official: should Mycoplasma genitalium and Trichomonas vaginalis be reportable sexually transmitted infections in the United States?

Abstract

The Centers for Disease Control and Prevention conducts surveillance for 5 sexually transmitted infections, yet Trichomonas vaginalis and Mycoplasma genitalium remain unmonitored despite their impact on women's health. Trichomonas vaginalis, the most common nonviral sexually transmitted infection in the United States, disproportionately affects marginalized populations and is associated with adverse pregnancy outcomes and increased susceptibility to HIV. Mycoplasma genitalium, an emerging sexually transmitted infection, is linked to cervicitis, pelvic inflammatory disease, infertility, and antibiotic resistance, yet its prevalence is estimated rather than systematically tracked. Current Centers for Disease Control and Prevention guidelines outline 7 criteria for determining a reportable disease: frequency, severity, disparities, cost, preventability, communicability, and public interest. However, it has been argued that only 3 of these criteria have been fulfilled for Trichomonas vaginalis and Mycoplasma genitalium, preventing their designation as reportable sexually transmitted infections. Limited public health funding and the lack of a national surveillance program result in an underestimation of the national sexually transmitted infection burden, thus limiting efforts to mitigate the associated sexually transmitted infection-related morbidity.