Strategy to manage STDs as a programmatic action for the prevention of sexual transmission of HIV in the state of São Paulo - Brazil: a favourable outlook
H. Alencar1, E. Grecco1, M.C. Gianna1, V. Pinto2
1Health State Secretariat, STD/AIDS State Program, Sao Paulo, Brazil, 2Ministry of Health - Brazil, STD, AIDS, Hepatitis Department, Brasilia, Brazil
Issues: Scientific evidence shows that treating STDs helps to reduce the risk of acquisition and sexual transmission of HIV. Although that is relevant to the practice professionals working with HIV/AIDS, no clear guidelines have been set out in state policy.
Description: The state programme has elaborated a proposal of guidelines for addressing syphilis, HPV infection, and the syndromes: genital ulcer, urethral and cervical/vaginal discharge, and pelvic pain among people living with HIV and AIDS (PLHA). It has been presented and discussed at round tables with health staff and NGO representatives and at the state meeting on Prevention against STD/AIDS attended by 600 participants.
The meeting recommended the incorporation of following actions into all health care actions directed at PLHA: assess the risk of STD presence in routine consultations: sexual background, recent history of STD, drug and alcohol consumption; discuss the inter-relations STD/HIV/AIDS as part of the assistance; trace asymptomatic STDs and treat them promptly in health care routines for PLHA; treat all STDs promptly and investigate neurosyphilis should there be any neurological symptom especially in late-diagnosed syphilis or latent syphilis of unknown duration.The suggestions and criticisms are being incorporated into final version which will be submitted to the state's Scientific Committee for STDs for approval and then published as a handbook.
Lessons learned: Participative elaboration enhanced strategy visibility and legitimacy and facilitated the implantation of the new directives in the state although the discussions were clouded by a lack of objectivity because the contents were diluted in the overall meeting agenda. A specific event would be more productive.
Next steps: Publish the handbook and launch it at the STD/HIV/AIDS health professionals meeting in September 2010 in São Paulo.
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