Scoping Review of Factors Associated With Treatment of Bacterial Sexually Transmitted Infections

To explore experiences related to sexually transmitted infection (STI) treatment guidelines and the influence of social determinants of health (SDOH) on the treatment of STIs.

We followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews) protocol. Three databases (CINAHL, MEDLINE, APA PsycInfo) were searched.

We identified peer-reviewed articles focused on treatment in the United States published from 2014 to 2024 in English. Titles and abstracts of 247 articles were reviewed; 16 were included in this synthesis.

We extracted data based on methodology, population, infection, and key findings related to individual-, interpersonal-, and ecological-level factors that impact effective treatment.

Twelve articles (75%) were quantitative, three (19%) were qualitative, and one (6%) was mixed-methods. Four themes were identified: Medication Adherence, Partner Notification/Treatment, SDOH/Social Context, and Interventions. Five articles described patient medication adherence challenges, and 13 articles focused on partner notification and treatment. Of the 14 articles that examined specific SDOH/social context, intimate partner violence was most frequently explored. Language barriers, sexual gender minority identity, and income-related barriers were also identified as relevant to STI treatment. No articles addressed abstinence from intercourse during the treatment period.

Findings suggest that SDOH/social context influence patient treatment adherence and bacterial STI outcomes. Of the SDOH, intimate partner violence was commonly highlighted as a barrier to partner notification, medication adherence, and treatment completion. Systems-level interventions were more effective than individual-level interventions. A syndemic framework may improve STI treatment outcomes by addressing sociocultural and structural factors alongside biomedical priorities.