Thermo Fisher Scientific is the world leader in serving science, with a mission ‘to enable our customers to make the world healthier, cleaner and safer’. Within its Genetic Testing Solutions team, the focus is on developing diagnostic solutions for a number of disease areas, including sexually transmitted infections (STIs).
Jelena Feenstra works as a Senior Manager for Medical and Scientific Affairs at Thermo Fisher Scientific. Her background is mainly in genetics, cytogenetics and genomics and she has worked extensively in diagnostics and research. At Thermo Fisher Scientific, Feenstra and her colleagues look to bridge molecular biology with clinical medicine.
“I work to bring these two fields together, by developing innovative solutions that help advance science and the practice of medicine, with the ultimate goal of impacting patient lives,” she said. “We envision this in the field of infectious diseases, oncology, personalised medicine, reproductive health and much more.”
The impact of COVID-19 on sexual health
Moving quickly in disease management is always important, and testing is the first step in helping to manage the spread of any infectious disease, including STIs.
Feenstra says: “Patients presenting symptoms, who think they are at risk, or have come in contact with an individual who has been exposed or infected, should get tested as soon as possible.”
She adds that many patients with STIs do not show any symptoms, while the presence of infection can impact their health and they can transmit the infection to others, and that this is why screening programs are in place and regular participation in screening is important.
She says: “Once informed of their infection status, patients can discuss with their clinicians the most appropriate treatment and how to make sure they are not spreading the infection to others.From a public health perspective, having accurate testing data aids officials in monitoring how the infections are spreading and what areas may be having surges.
“This allows them to properly allocate resources as needed if certain communities are witnessing spikes.”
According to the World Health Organisation, each year there are 374m new STI infections, which are mostly chlamydia, gonorrhoea, syphilis and trichomoniasis. Those who have had an STI often ask why the STI test can’t be done at home?
“Technology isn’t currently ready to support ‘true’ at-home testing for STIs, in the same way that antigen tests helped with COVID-19 diagnostics,” says Feenstra. “The current at-home solution for STIs involves self-collection of samples in the comfort of one’s own home and then shipping out the samples to be tested in a laboratory, which Feenstra sees as an advantage in terms of privacy and ease of access.”
She adds: “Labs typically use molecular diagnostic tests which are able to provide highly accurate results quickly and offer the advantage of testing for multiple STIs from one sample, regardless of whether the sample was self-collected or collected by a healthcare professional.”
However, the quality of sample is very important for obtaining reliable results and typically sample collection in a healthcare setting offers a more standardised approach.
With self-collected samples the concerns are mainly regarding individuals being able to correctly collect the sample and in sufficient volumes, as well as whether the sample integrity will be impacted by shipping conditions.
“Closely following the instructions for self-collection of samples is therefore very important to avoid the need for repeated testing and thus prevent delays in treatment,” says Feenstra. “At the same time, the at-home collection devices are constantly being improved to ensure sample quality. While progress is ongoing, the immediate priority should be on getting people tested for STIs and making sure they’re getting the treatment they need, whether it be in the conventional hospital-lab based system or the convenient at-home collection followed by lab testing.”
While data are still coming in, so far it appears that the pandemic has had a marked impact on the spread of STIs. The report by the US Centers for Disease Control and Prevention (CDC), based on surveillance data from 2020, showed that STIs decreased during the early months of the COVID-19 pandemic, but resurged and surpassed previous years by the end of 2020.
Feenstra says: “One of the key factors of the early decline appeared to be underdiagnosis and reduced screening efforts rather than an actual reduction in new infections, with more individuals staying home instead of going to their health care provider out of concern of contracting COVID-19.”
As healthcare resources were diverted towards fighting COVID-19, laboratory and testing shortages additionally contributed to the underreporting infections in surveillance data.
Yet by the end of 2020 it was clear the STI epidemic had worsened and that the true incidence of STIs were higher than in previous years.
“Since then, this trend has continued and STIs seem to be a major concern from a public health standpoint,” says Feenstra.
How hospitals can better support LGBT+ healthcare
Healthcare services can better support the LGBT+ community in a variety of ways, says Feenstra:
“On the testing side, we have advanced tools like molecular diagnostics to support needs better than ever before. This helps all people including people in the LGBTQ+ community, who are commonly impacted by STIs.”
The pandemic advanced the accessibility of technology used in diagnostics out of necessity. Now, labs around the world have myriad testing infrastructures with far better capabilities than ever before.
“What we need to focus on is finding ways to provide better access to these services,” she says. “For instance, reimbursement issues can often get in the way, and take health care decisions away from providers and their patients. Now that the tools are in hand, we need to be able to use them properly.”
Outside of testing, the focus really should be on other methods of disease prevention, which can only be achieved with adequate counselling.
“In addition, understanding the specific barriers that members of the LGBTQ+ community face and acting to actively remove those barriers is critical.”
Over the next 12 months, Thermo Fisher Scientific is committed to continuing to work on advancing the access to molecular diagnostic tools that help to progress the standard of care in STIs and other infectious diseases.
“We can do this by improving education and communication about the technologies currently available, so patients know what they can expect and so laboratorians know what sort of services they should be offering,” says Feenstra. “On the policy side, we can continue to gather real-world data on these tools and benefits they provide to patient care and outcomes.”
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