Non-HIV sexually transmitted infections among women of childbearing age

Non-HIV sexually transmitted infections (STIs) among women of childbearing age (WCBA) are a major cause of severe long-term reproductive health sequelae. However, a comprehensive analysis of the spatiotemporal trends, health inequalities, and future predictions of the disease burden specific to this population, based on global data, is still lacking. This study conducted a secondary analysis based on the Global Burden of Disease 2021 data to systematically estimate the burden of non-HIV STIs among WCBA globally from 1990 to 2021. We integrated multiple analytical approaches, including Joinpoint regression analysis, health inequality assessment (involving Sociodemographic Index [SDI] correlation and concentration index analysis), and predictive modeling, to comprehensively reveal the spatiotemporal evolution, inequalities, and future trends of the disease burden. Globally, the incidence and prevalence of non-HIV STIs showed fluctuating, nonlinear temporal patterns over the past 3 decades, while disability-adjusted life years (DALYs) displayed no sustained long-term decline. Trichomoniasis and chlamydial infection were the most significant contributors to the overall burden. The distribution of the disease burden revealed substantial geographical inequalities, with DALYs showing a strong negative correlation with SDI ( R  = −0.59, P  < .001). Low-SDI regions, such as Western sub-Saharan Africa, bore the highest burden, whereas Western Europe had the lowest. Health inequality assessment indicated that although inequalities related to DALYs modestly improved, incidence-based inequalities intensified. Under a projection scenario based on historical age-period-cohort patterns, global incidence and DALY rates are projected to increase, exceeding 14,000 cases and 40 DALYs per 100,000 population by 2050, respectively. The burden of non-HIV STIs among WCBA remains persistent and unequally distributed globally. Model-based projections suggest that this burden may increase if historical patterns continue. New infections are increasingly concentrated among socioeconomically disadvantaged groups. These findings support targeted and equity-oriented prevention strategies to reduce disease burden and promote health equity.