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About Our Work: Prevention and Care of Sexually
Transmitted Infections
(Last Updated: January 2005) |
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A strong link exists between sexually transmitted infections (STI) and the
sexual transmission of HIV infection. Many studies provide compelling evidence
that STI is a co-factor for HIV transmission.
An untreated STI can increase the risk for both the acquisition and
transmission of HIV by up to tenfold. This suggests that STI control may
potentially play an important role in the reduction of HIV transmission,
especially since the predominant mode of transmission of HIV in sub-Saharan
Africa is sexual.
Clinical services offering STI care also provide an important entry point for
people at high risk for HIV, not only for diagnosis and treatment but also for
information and education.
A comprehensive "public health package" for STI prevention and care should
include the following components:
- STI case management (diagnosis, treatment, risk reduction counseling) for
most at-risk populations, including HIV positive persons;
- integration of voluntary HIV counseling and testing services into routine
STI clinical management;
- reinforcement of existing STI clinical services to become "active" entry
points for HIV treatment and care;
- surveillance of STIs in different population groups as the basis for
intervention planning and as an evaluation tool for HIV prevention
interventions.
With U.S. government funding, the Global AIDS Program (GAP) has supported the
following STI prevention and care activities in several GAP countries, including
Botswana, Mozambique, Ethiopia, and Guyana:
- development of syndromic case management treatment guidelines, an approach
that identifies a consistent group of symptoms and recommends treatment
guidelines targeted to the infections most likely to cause those symptoms;
- development of training materials for health workers and clients;
- training in syndromic case management, including partner services, for
trainers and front-line health workers;
- monitoring systems for program evaluation and supervision
- development of STI laboratory services;
- evaluation of the effectiveness, acceptability, and coverage of quality
STI care.
Targeted STI interventions help reduce HIV transmissionTo be
effective, sexually transmitted infection (STI) activities must target those
populations most at-risk for infection. These populations often have the highest
prevalence of STI and HIV and therefore, the greatest need for care and
treatment.
In Tanzania, improving STI case management through adoption of a syndromic
treatment approach resulted in a 42% reduction in HIV transmission.
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