Spotlights on Health and Rights

Key topics in the Heilbrunn Department of Population and Family Health

Reproductive Health

Prevention of Sexually Transmitted Infection

In 2003, The World Health Organization (WHO) conceptualized the prevention and control of STIs as a "public health package" consisting of the following components:

  • The promotion of safer sexual behavior
  • Condom programming--encompassing a full range of activities from condom promotion to the planning and management of supplies and distribution
  • Promotion of health care-seeking behavior
  • Integration of STI prevention and care into primary health care
  • The provision of specific services for populations at risk--such as female and male sex workers, adolescents, long-distance truck drivers, military personnel and prisoners--by health care facilities, private clinics, and other service providers.
  • Comprehensive case management of STIs
  • Prevention and care of congenital syphilis and neonatal conjunctivitis
  • Early detection of symptomatic and asymptomatic infections

Similarly, the 2002 CDC Clinical Prevention Guidelines base the prevention and control of STDs on the following five major concepts:

  • Education and counseling of persons at risk on ways to adopt safer sexual behavior,
  • Identification of asymptomatically infected persons and of symptomatic person unlikely to seek diagnostic and treatment services,
  • Effective diagnosis and treatment of infected persons,
  • Evaluation, treatment, and counseling of sex partners of persons who are infected with an STD
  • Pre-exposure vaccination of persons at risk for vaccine-preventable STDs.

The STI Syndromic Approach, is one example of a strategy specifically designed to address STI infection in areas of the world where resources are scarce, laboratory testing is not readily available, and rates of STI and HIV are high. Syndromic management involves the treatment of signs and symptoms using an algorithm of decision points to treat symptoms (i.e. vaginal discharge, urethral discharge, genital ulcers and pelvic pain), rather than laboratory tests. Although the identification of cervical infections such as gonorrhea and chlamydia are not highly effective with this method, use of the method resulted in a 42% reduction of HIV transmission in Tanzania.

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