Spending money to save money.

t is a challenging time to be taking up the reins of Sexually Transmitted Infections. After a prolonged period of decline, there are epidemics of bacterial STIs in the United Kingdom and Western Europe, including outbreaks of syphilis. HIV continues to escalate; the prevalence of HIV is escalating due to persistent or rising incidence combined with increased survival. Globally we face major epidemics of HIV in India and China that could rival that of sub-Saharan Africa. 1 For people with access to health care treatment is improving for viral infections , including HIV. This offers great hopes but is also placing complex demands on clinicians and patients, not least those of compliance and possible " treatment optimism. " 2 3 And as soon as we get one step ahead of the bugs with drugs, accelerated resistance threatens these gains. There are exciting developments in diagnostic techniques that increase sensitivity and specificity, identify subtypes, and may provide rapid answers in near patient tests. The impact of these advances is yet to be fully felt, and this issue of STI includes a number of articles on the clinical, epidemiological, and psychological implications of type specific screening for HSV antibodies 4–6 and on approaches to chlamydia screening in the community. In the United Kingdom there are particular challenges in relation to the delivery of sexual health care, with demand outstripping capacity for services. The roles of all professionals within the field of sexual health and HIV is changing, with more nurse led patient care, and an emphasis on networks of care that include a bigger role for the primary care team. Such changes require careful governance of clinical medicine, an issue that also affects clinicians in the United Kingdom, who will be required to demonstrate ongoing competence through a revalidation process. Keeping up with all these developments is difficult but essential, and we think that Sexually Transmitted Infections is already a useful tool for practitioners. In taking on the roles of joint editors we hope that we can continue to improve the journal and make it even more relevant and useful. We see the major role of the journal as providing the evidence base, in a digestible form, to inform practitioners, trainees , and researchers in our field. In addition to publishing peer reviewed papers, we aim to have more systematic reviews, state of the art leading articles, and regular reports on trends …