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Sexually Transmitted Infections (STI) rank among the top five conditions for which sexually active adults seek health care in the developing countries. As per the community based STI/RTI prevalence study (2003), over 6% of the adult population in India suffer from one or the other STI/RTI episode annually. There is enough evidence to suggest that early diagnosis, treatment and management of STI/RTI including inducing behavior change through education amongst the target groups will reduce transmission of STI/RTI and HIV (Lancet 1995; 346:530-536). Failure to diagnose and treat STI/RTI at an early stage in women of reproductive age group may result in serious complications and consequences, including infertility, fetal wastage, ectopic pregnancy, ano-genital cancer and premature death, as well as neonatal and infant infections.
Effective control of STI/RTI is a strong and most cost effective strategy for reducing/preventing transmission of HIV. This is because both sexually transmitted Infections and HIV have same routes of transmission and occur in individuals practicing similar type of high risk behavior i.e. unsafe sexual intercourse. Also, the presence of a STI/RTI in the sexual partner increases the risk of acquisition of HIV from an infected partner by 8-10 fold. The presence of HIV affects the clinical presentation, course, diagnosis as well as management of STI/RTI.
NACO is duly addressing the issues of STI/RTI morbidity and NACP III envisages coverage of about 15 million STI/RTI episodes annually during the programme. NACO through its network of 938 designated STI/RTI clinics (situated at government health care facilities at district level and above) is providing free standardized STI/RTI services. These clinics have been branded as “Suraksha Clinics” and provide sexual & reproductive health services. Standardized training to the medical and paramedical personnel based on syndromic case management approach is being provided and counseling services from trained counselors are made available at these clinics. Colour coded syndromic drug kits and RPR test kits are being centrally procured and supplied to these clinics.
Laboratory support for STI/RTI has been strengthend through a network of seven regional STI centers.
STI/RTI services are also being expanded though effective integration with the RCH-II programme, NACO and RCH division have jointly drafted technical guidelines on management of STI/RTI so as to ensure uniformity of service delivery across all facilities. Private sector has been meaningfully involved through identification of preferred private providers to give services to the high risk group population served through TI projects.