Sexual and reproductive health 5 - Global control of sexually transmitted infections


Low, N; Broutet, N; Adu-Sarkodie, Y; Barton, P; Hossain, M; Hawkes, S; (2006) Sexual and reproductive health 5 - Global control of sexually transmitted infections. Lancet, 368 (9551). pp. 2001-16. ISSN 0140-6736 DOI: https://doi.org/10.1016/S0140-6736(06)69482-8

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Abstract

Sexually transmitted infections other than HIV are important global health issues. They have, however, been neglected as a public-health priority and control efforts continue to fail. Sexually transmitted infections, by their nature, affect individuals, who are part of partnerships and larger sexual networks, and in turn populations. We propose a framework of individual, partnership, and population levels for examining the effects of sexually transmitted infections and interventions to control them. At the individual level we have a range of effective diagnostic tests, treatments, and vaccines. These options are unavailable or inaccessible in many resource-poor settings, where syndromic management remains the core intervention for individual case management. At the partnership level, partner notification and antenatal syphilis screening have the potential to prevent infection and re-infection. Interventions delivered to whole populations, or groups in whom the risks of infection and onward transmission are very high, have the greatest potential effect. Improvements to the infrastructure of treatment services can reduce the incidence of syphilis and gonorrhoea or urethritis. Strong evidence for the effectiveness of most other interventions on population-level outcomes is, however, scarce. Effective action requires a multifaceted approach including better basic epidemiological and surveillance data, high quality evidence about effectiveness of individual interventions and programmes, better methods to get effective interventions onto the policy agenda, and better advocacy and more commitment to get them implemented properly. We must not allow stigma, prejudice, and moral opposition to obstruct the goals of infectious disease control.

Item Type: Article
Keywords: SIMPLEX-VIRUS TYPE-2, RANDOMIZED CONTROLLED-TRIALS, PELVIC-INFLAMMATORY-DISEASE, CHLAMYDIA-TRACHOMATIS, SYNDROMIC, MANAGEMENT, SYPHILIS CONTROL, CONGENITAL-SYPHILIS, MALE CIRCUMCISION, GENITAL HERPES, HIV-INFECTION, Contact Tracing, Female, Health Priorities, Humans, Male, Mass Screening, Prevalence, Public Health, Sexually Transmitted Diseases, diagnosis, epidemiology, prevention & control, World Health
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre: Social and Mathematical Epidemiology (SaME)
PubMed ID: 17141708
Web of Science ID: 242593300033
URI: http://researchonline.lshtm.ac.uk/id/eprint/10571

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