31.6.4  Key issues regarding STIs and HIV infection

You need to keep in mind the following essential points about the relationship between HIV and STIs. Firstly, an obvious point in common between STIs and HIV is behavioural. For example, unprotected sexual behaviour exposes people to both HIV and other STIs as you learned in Section 31.2.1 and elsewhere in this Module. Equally, the consistent use of condoms can prevent both kinds of infection. So, you need to educate and counsel your clients about the proper and consistent use of condoms to reduce the risk of transmission of both HIV and other STIs.

Secondly, STI control is also important for preventing the spread of HIV from PLHIV, which you learned in Study Session 29 on positive living. PLHIV are more likely to transmit HIV to others if they also have another STI. PLHIV should thus be taught how to recognise STI symptoms and be encouraged to seek care promptly if they think they may have an infection.

Note that all STI cases that you identify at your health post and in your community have to be referred to the nearest health centre for treatment. In the health centre, STI treatment should be provided along with the following key interventions:

• Educating clients about the transmission, treatment and control of STIs and HIV
• Providing risk reduction counselling by focusing on the prevention of STIs and HIV
• Condom promotion and provision for all clients
• Consideration of HIV-related illness and offering provider-initiated counselling and testing
• Partner counselling and treatment: management of partners for STIs is an essential component of STIs to stop further recurrent infection among partners
• Encouragement for HIV testing through provider-initiated counselling
• Referral of patients and their partners to counselling units and laboratories for HIV and syphilis testing, or to higher health care if they do not respond to syndromic treatment of STIs.