STRATEGIES FOR STI PREVENTION AND CONTROL

Objectives: KEY CONCEPTS you will learn: Explain strategies of STIs prevention and control Discuss challenges of STI prevention and control

The Main Aims of STIs Prevention and Control are:- Interrupting the transmission of STIs Prevent development of disease and complications Reducing the risk of acquiring and transmitting HIV

Prevention and Control of STIs Involves Early diagnosis and treatment Promotion of safer sexual behavior Promotion of health care-seeking behavior, Targeting vulnerable groups

Primary prevention Safer sexual behaviors abstain from sexual activity altogether delaying the age of sexual debut life-long mutual monogamy engaging only in non-penetrative sex acts engaging in penetrative sex acts only if condoms (male or female) are used

Secondary prevention Promoting STI care-seeking behavior, through: public education campaigns providing non-stigmatizing and non-discriminatory health facilities providing quality STI care ensuring a continuous supply of highly effective drugs ensuring a continuous supply of condoms

Secondary prevention…Cont’d Rapid and effective treatment of people with STIs: comprehensive case management of STI syndromes to make a correct diagnosis to provide correct antimicrobial therapy for the STI syndrome to educate on the nature of the infection, safer sexual behavior, safe sex acts and risk reduction in order to prevent or reduce future risk-taking behaviour to educate on treatment compliance

Secondary prevention…Cont’d Comprehensive management ….Cont’d to demonstrate the correct use of condoms and provision of condoms to advise on how the patient’s partners may be treated and to issue a Partner Referral card for the patient to pass on to his/her partner(s). training of service providers in case management

Secondary prevention…Cont’d Case finding and screening: examining minimally symptomatic women attending clinics for maternal and child health and family planning partner notification and treatment education, investigation and treatment of targeted population groups who may have placed themselves at risk of infection testing of blood donors for syphilis, HIV and hepatitis B community-based screening

Secondary prevention…Cont’d Provision of prophylactic antibiotics against major STIs for victims of sexual violence Integration of STI services within primary care

CHALLENGES OF CONTROLLING STIs

Challenges are due to: Factors related to health system Biological factors Social and behavioral factors

Health System Factors Health service may be unavailable, too far way, expensive, or considered stigmatizing There may be little emphasis on education and other efforts to prevent STIs Health services may not have effective drugs Difficulty of partner management

Biological factors 70%-80% of infected women may be asymptomatic and so will not seek treatment Such people will continue to be infected, risking complications and perhaps infecting others

Social and behavioral factors Reluctance to seek health care Ignorance or misinformation A preference for alternative health care service Reluctance to follow safe sex practices The social stigma often attached to STI

Social and behavioral factors ….Cont’d Failure to take full prescribed course of treatment Difficulty of notifying sexual partners