Thursday, February 3, 2011

FROM THE STI CONTROL & MANAGEMENT DESK OF UNIVERSAL HEALTH


                                          No condom No sex 

Part Three

1.11 How STI management can help

Treatment and cure from STIs decrease -
  • Susceptibility to HIV
  • Concentration of viral load in genital secretion
  • Shedding of HIV in genital secretion
  • STIs & HIV both associated with unprotected sex with multiple partners. So same measure that prevent STIs can also prevent sexual transmission of HIV
  • Spread of HIV infection in the community
  • Reduces serious complications of mothers & children like cervical cancer, ectopic pregnancy, infertility, still birth

1.12 Objectives of STI Management and control:

·        To prevent new infections
·        To treat those who are symptomatic & seeking treatment
·        To treat those who are symptomatic but not seeking treatment
·        To treat those who are symptomatic, seeking treatment without success due to lack of quality STI services
·        To identify and treat those who are asymptomatic
·        To treat the partners of the cases


1.13 Basic approaches of prevention and control of STIs

There are three basic approaches to prevent and control STIs: -
  1. Reduction of STI load/burden of the community (prevalence)
  2. Reduction of  new STI cases (incidence)
  3. Strengthening STI reporting and surveillance


Table 1: Reduction of STI prevalence

Major activities

         Quality STI services
         Early diagnosis and treatment of STIs among high risk groups
         Presumptive treatment of STIs
         Simultaneous treatment of the partners of the STI cases
         Promotion of STI services and health seeking


Table 2: Reduction of STI incidence

Major activities

         STI prevention by correct and consistent use of condom
         Creating sufficient awareness on STIs and HIV through strategic communication
         Prevention of STI relapse/re-infection after treatment by consistent safe sex
         Creating enabling environment of safe sex
         Practice of non-penetrative sexual acts
         Practice of abstinence, fidelity, delayed sexual debut
         This is applicable to prevention of sexual route of HIV transmission as well



Table 3: Comprehensive package of STI Services


  • Syndromic management of STIs
  • Etiologic management of STIs
  • Presumptive Treatment for asymptomatic infections
  • Treatment of the partners
  • STI Screening through risk assessment & screening tests
  • Condom promotion
  • Information Education Communication
  • Promotion of services and health seeking


            (Peer Educators of STI clinic of Sanur, Bali, Indonesia)

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