Does Intense Sexually Transmitted Infection Screening Cause or Prevent Antimicrobial Resistance in Sexually Transmitted Infections? It Depends on One's Underlying Epistemology. A Viewpoint.

Sexually Transmitted Diseases
Chris Kenyon

Abstract

Certain authors argue that intensive sexually transmitted infection (STI) screening is a crucial way to reduce STI prevalence and prevent the emergence and spread of antimicrobial resistance (AMR) in STIs. Others argue the opposite: intense screening in high STI prevalence populations has little effect on prevalence and is likely to select for AMR. In this viewpoint, I argue that these radical differences in outlook stem, in part, from different conceptual frameworks of the determinants of STI prevalence and AMR. In the absence of strong evidence from randomized controlled trials, our brains interpret the weaker evidence from other sources in different ways, depending on our underlying epistemologies. To illustrate the argument, I contrast a predominantly biomedical individualist conceptual framework with a more ecological conceptual framework. I argue that if one's conceptual framework is based in biomedical individualism, then one is more likely to think that screening reduces STI prevalence and less likely to appreciate the connection between screening, antimicrobial exposure, and AMR than perspectives grounded in ecological frameworks.

References

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May 18, 2011·Antimicrobial Agents and Chemotherapy·Fernando BaqueroFernando de la Cruz
Jul 7, 2012·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Chris Kenyon, Robert Colebunders
Mar 20, 2013·Frontiers in Microbiology·Fernando BaqueroTeresa M Coque
Jul 2, 2014·Clinical Microbiology Reviews·Magnus Unemo, William M Shafer
Dec 3, 2014·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Chris Richard KenyonR Matthew Chico
Dec 10, 2014·Expert Review of Anti-infective Therapy·Thomas A PetermanHillard Weinstock
Jun 6, 2015·American Journal of Public Health·Mervyn Susser, Ezra Susser
Mar 12, 2016·Sexually Transmitted Diseases·Kara K OsbakChris Richard Kenyon
Jul 14, 2017·The Lancet Infectious Diseases·Magnus UnemoChristopher K Fairley
May 3, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Huan V DongJeffrey D Klausner
Jul 31, 2019·Nature Microbiology·Leonor Sánchez-BusóSimon R Harris

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Citations

Jan 29, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Paul C Adamson, Jeffrey D Klausner
Nov 4, 2021·Journal of Clinical Microbiology·Paul C Adamson, Jeffrey D Klausner
Jan 5, 2022·International Journal of STD & AIDS·Chris KenyonChristophe Van Dijck

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