Predictors of Recent Incidence Trends in Sexually Transmitted Infections: A Narrative Synthesis

Objective Increasing trends in sexually transmitted infections (STIs) warrants an examination of the potential factors behind this phenomenon. This systematic review aims to synthesize evidence on the predictors of recent trends in chlamydia, gonorrhea, HIV, and syphilis.Methods A systematic search was conducted via scientific databases (i.e., CINAHL, Embase, PubMed, PsychINFO, Scopus), expanded by citation-mining techniques, and complemented by grey literature searches. The included studies met the following criteria: (a) employed statistical trend analyses; (b) reported predictors of our targeted STI diagnoses; (c) included incidence data within the period of interest; and (d) consisted of nationally representative population samples. Findings were evaluated and summarized via narrative synthesis methods.Results A total of 13,085 published and 68 grey literature records were reviewed, of which 16 studies were included containing minimal sociodemographic and trend information on STI incidence. The majority of the sample dealt with HIV diagnoses (k = 12), followed by syphilis (k = 2), gonorrhea (k = 2), and chlamydia (k = 2). Overall, the available information linking predictors of behavioral relevance to incidence trends across the targeted STIs was scarce.Conclusions The implications of these findings are discussed with an emphasis on the necessary contextual and behavioral information as part of surveillance data for an effective understanding of STIs drivers that acknowledges social diversity and multi-level approaches.