HIV/AIDS

Supporting Information

Sexually transmitted infections (STIs) are infections that are spread through sexual contact, either through the exchange of body fluids (semen, vaginal fluid or blood) or by contact with the skin of the genital area (particularly if there are lesions such as blisters, abrasions or cuts, often caused by the STI itself).

STIs often cause serious physical suffering and damage.

Any STI, such as gonorrhoea or syphilis, can increase the risk of catching or transmitting HIV. Persons suffering from an STI have a 5 to 10 times higher risk of becoming infected with HIV if they have unprotected sexual intercourse with an HIV-infected person.

• Correct and consistent use of latex condoms when engaging in sexual intercourse – vaginal, anal or oral – can greatly reduce the spread of most STIs, including HIV.
• People who suspect that they have an STI should seek prompt treatment from a health worker in order to be diagnosed and get treatment. They should avoid sexual intercourse or practice safer sex (non-penetrative sex or sex using a condom). If found to have an STI, they should tell their partner. If both partners are not treated for an STI, they will continue infecting each other with the STI. Most STIs are curable.

A man infected with an STI may have pain or discomfort while urinating; discharge from his penis; or sores, blisters, bumps and rashes on the genitals or inside of the mouth. A woman infected with an STI may have discharge from the vagina that has a strange colour or bad smell, pain or itching around the genital area, and pain or unexpected bleeding from the vagina during or after intercourse. More severe infections can cause fever, pain in the abdomen, and infertility. However, many STIs in women produce no symptoms at all – and some STIs in men also may not have any noticeable symptoms.

Also, not every problem in the genital area is an STI. There are some infections, such as candidiasis and urinary tract infections, that are not spread by sexual intercourse but cause great discomfort in the genital area.

The traditional method of diagnosing STIs is by laboratory tests. However, these are often unavailable or too expensive. Since 1990, WHO has recommended 'syndromic management' of STIs in people with symptoms of STI. The main features of syndromic management are:

• classification of the main germs by the clinical syndromes produced
• use of flow charts derived from this classification to manage a particular syndrome
• treatment for all important causes of the syndrome
• notification and treatment of sex partners
• no expensive laboratory procedures.

The syndromic approach using flow charts offers accessible and immediate treatment that is cost-effective and efficient.