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Accurate diagnosis, treatment and prevention of HIV and sexually transmitted infections (STIs) should be priorities for health systems around the world. Untreated or undertreated STIs can lead to infertility, cancer, chronic pelvic pain, and facilitate HIV transmission.1 New and existing treatments, tests and prevention strategies therefore need to be rigorously evaluated to assess their benefits and harms as this information is important for clinical decision-making and policy and guideline development. This editorial introduces the new Sexually Transmitted Infections Cochrane Review (STICR) group, which aims to support authors in summarising evidence about interventions and diagnostic tests used for genital tract infections.
The Cochrane Collaboration focuses on developing and maintaining systematic reviews of healthcare interventions to allow well-informed decisions about healthcare.2 A systematic review is an assessment and evaluation of all research studies that examine a particular clinical problem,3 using explicit, pre-stated methods that reduce bias, thus providing more reliable findings from which conclusions can be drawn and decisions made.4 The Cochrane Database of Systematic Reviews forms the main part of the Cochrane Library, and has over 5000 reviews. According to Journal Citation Reports its impact factor for 2012 was 5.78,5 and more than 50% of the world has free access to the Cochrane Library.6
The STICR group is one of 52 groups of the Cochrane Collaboration. Its scope includes diagnosis, treatment and prevention of all STIs and genital tract infections, but does not include HIV/AIDS (these are covered by another group). The STICR group started in 1997 as the Sexually Transmitted Diseases Cochrane Review Group but was eventually incorporated into the Cochrane HIV/AIDs Group. In 2006 the group became a satellite of the HIV/STI group in Brazil but was closed in 2009. In 2012, the STICR group was re-registered by the Cochrane Collaboration and was established at the Clinical Research Institute of the Universidad Nacional de Colombia, Bogotá, Colombia. The group has an international editorial board (listed at the end of this article) and is working with interested clinicians, researchers and consumers from around the world.
The STICR group has published nine reviews and nine protocols since 2012 in the Cochrane Library, with a number of other protocols in development. Individuals or groups who are interested in preparing systematic reviews of STIs should contact the editorial office to register a title, which will be assessed by the editorial board. Once the title is approved, a protocol is developed and published according to the Cochrane Collaboration standards. After this, reviews can be prepared, which will also be peer reviewed. We aim to have all Cochrane reviews updated 2 years after publication.
The reviews aim to provide evidence about the effectiveness and safety of interventions which seek to modify behaviours that increase the risk of STI acquisition, to prevent STI, and to guide the treatment of STI with an aetiological or syndromic approach. The group has broadened its scope and is now starting work on diagnostic systematic reviews for evaluating rapid tests used at the point of care and other customary diagnostic tests for STI. Our published reviews include: ‘Genital ulcer disease treatment for reducing sexual acquisition of HIV’,7 ‘Azithromycin versus penicillin G benzathine for early syphilis’,8 ‘Topical microbicides for prevention of STI’9 and ‘Strategies for partner notification for STI including HIV’.10
Additionally, the Group has disseminated and supported several evidenced-based initiatives. It has worked closely in the development of two Colombian evidence-based clinical practice guidelines—namely, ‘Syndromic management of genital tract infections and STIs’11 and ‘Integral management of gestational and congenital syphilis’ available at http://www.sti.cochrane.org. The STICR group has supported assessments of several health technologies for health authorities in Colombia and has collaborated with several Colombian guideline development groups. We are also working with WHO to prepare a review on the first episode of herpes infection, which will be incorporated into WHO guidelines for STIs.
Another closely aligned Cochrane group is the Cochrane HIV/AIDS Group (CHIVG), which was established in 1997 and is based at the University of California, San Francisco. Led by coordinating editor Dr George W Rutherford, CHIVG has published more than 100 reviews on topics relevant to behavioural, social and policy approaches to HIV prevention; biomedical HIV prevention interventions; service delivery and organisation of care for those with HIV; and HIV/AIDS therapeutics. In addition to publishing reviews produced by Cochrane authors from more than 40 countries, the CHIVG's editorial team has worked closely for many years with WHO and other key entities, commissioned by these agencies to develop systematic reviews and other evidence assessments. These are used to inform global guidelines and policy statements relevant to HIV/AIDS prevention, treatment and care. The CHIVG also has a satellite editorial base at the South African Centre in Cape Town. Since 2000, this satellite has coordinated a mentoring programme for sub-Saharan Africa-based, first-time Cochrane authors leading HIV/AIDS reviews. Detailed information about this group can be found at http://hiv.cochrane.org
The STICR group is now entering a new phase of activity and we welcome collaboration. We invite thematic experts, methodologists, networks, organisations, clinicians and consumers to work with both the STICR group and CHIVG. The Cochrane Collaboration hosts workshops for editors and authors of systematic reviews in different countries, and online educational resources are also available. We hope that with these renewed efforts decision makers, clinicians and consumers will be able to make the best decisions and improve the health of men and women at risk of, and with, STI and HIV/AIDS.
Anyone interested in joining us as an author, referee, or consumer or attending our workshops can visit our websites (http://sticr.cochrane.org/, http://hiv.cochrane.org/) or write to our managing editors (email@example.com, firstname.lastname@example.org). We look forward to hearing from the journal's readers.
STICR group editorial team The coordinating editor is Dr Hernando Gaitán Duarte, a gynaecologist with a special interest in pelvic inflammatory disease and STIs in women, assisted by Professor Cindy Farquhar, coordinating editor of the Cochrane Menstrual Disorders and Subfertility Review Group at the University of Auckland, New Zealand. The editorial team members are Marcela Torres (managing editor), John Feliciano (trial search coordinator) and Maria T Vallejo (trial search coordinator assistant).
Collaborators STICR group editorial board members: Eliana Martorano Amaral (Brazil), Edith Angel (Colombia), Luis Gabriel Cuervo (USA), Pio I Gomez (Colombia), Carlos Grillo Ardila (Colombia), Anne Lethaby (New Zealand), Nicola Low (Switzerland), Catherine Mathews (South Africa), Dimitris Mavridis (Greece), Suneeta Mittal (India), Carlos Eduardo Pinzón (Colombia), Ludovic Reveiz (Colombia), Tonantzin Ribeiro (Brazil), Carlos Rincón (Colombia), Helen Roberts (New Zealand), Nelcy Rodríguez (Colombia), Jonathan Ross (UK), Jorge Andrés Rubio (Colombia), Ariel Ruíz (Colombia), George Rutherford (USA), Jorge Tolosa (USA), Marialena Trivella (UK),Taryn Young (South Africa).
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.
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