Juana Shimizu is in the U.S. on research grants to study a parasite that causes malaria, and she’s been diagnosed with two other sexually transmitted infections. She also wants to write a memoir about her experiences in the developing world, like the one this week in this magazine, to help address the persistent and growing problem of poor women and girls dying as a consequence of disease.

“It’s like a ticking time bomb,” Shimizu says, recounting the stories of women who survived malaria in the 1970s and 1980s and who have since succumbed to chlamydia, gonorrhea and HIV. “It is just the worst. There’s so little support.”

Chlamydia is often diagnosed as a case of mistaken identity. An oral test can be used to screen for the parasite, but a vaginal swab can also identify infections. When men infected with chlamydia live together, their genital fluids carry the parasite, so it’s often missed when women who have it have their monthly exam—and can’t be found with oral or vaginal tests. And when women catch it as young as 14, it can be difficult to control.

Kathleen Himmelstein, who directs sexual-health services at a public-health agency in San Francisco, had both her partners infected with chlamydia and had to undergo treatment for both HIV and other STDs. “All the data shows, in my opinion, that if chlamydia is not treated, the complications are still very high in the lives of the women” in her care, says Himmelstein, 59, a mother of four.

Researchers have also found that sexually transmitted infections can get worse over time—the more serious the infection, the more likely it is to progress, and it can move from the bloodstream to the bladder or cervix, and then to the ovaries, uterus and even the brain, leading to more complications.

Himmelstein, who has had three kids, has a son with multiple sclerosis and a daughter with multiple sclerosis, and says she was one of the first women in her family to be diagnosed as having gonorrhea. “I’ve seen the effects firsthand,” she says. “So I’ve seen what it can do. You know, all your organs, even in a relatively early stage, can be affected.”

Since the early 1990s, chlamydia has been a major public-health problem for