Prevention of HIV
Sexually transmitted Infections

The Southern African region is undoubtedly the epicentre of the global HIV epidemic. Epidemiological and biological evidence strongly suggest that conventional STIs increase the risk of individuals transmitting and acquiring HIV. Thus efforts to limit the spread of the HIV/AIDS epidemic must include programmes aimed at preventing and controlling the spread of conventional STIs. During 2008, ACHAP provided both financial and technical support to the Ministry of Health to respond to the gaps identified in the national plan for scaling up HIV prevention within the context of STIs.

National Strategy for strengthening STI partner tracing and management

With financial and technical support from ACHAP, the Ministry of Health recruited a consultant team from Makerere University Medical School and School of Public Health, Uganda to facilitate the development of a national STI partner tracing strategy. This would strengthen partner tracing and management with the aim of reducing, further, the incidence and prevalence of STIs in the country. The strategy was completed and it describes the current partner tracing situation in the country, analyses the current STI situation and provides an exhaustive three-year strategy and implementation plan.
Training health care service providers in STI management and control

By end of December 2008, 400 service providers from different districts and hospitals had been trained on various areas of STI management. This exceeded the 2008 set target of 300 health care providers to be trained. 238 were trained on the new STI management protocols while 69 were trained as TOTs on STI monitoring and evaluation and clinical mentoring. 93 private medical practitioners were trained on STI syndromic management and surveillance. This training is meant to provide standardised approaches to the management of STIs in the country within the context of a generalised HIV epidemic.

Strengthening IEC/BCC for STI

ACHAP supported the production of IEC/BCC support materials for the STI programme particularly targeting clients at health facilities. A total of 160,000 copies of both English and Setswana brochures and flyers were printed and distributed. These included 40,000 brochures on Genital herpes, 40,000 of Genital warts, 40,000 on vaginal discharge and 40,000 on STI partner tracing. To support these materials, a series of radio talk shows were hosted addressing the topics included in the print materials. Twenty two radio talk shows were hosted on RB2 (Radio Botswana) over a period of twenty two weeks. The purpose of these talks was to provide opportunity for community members to ask questions and receive further information and clarifications on STIs and the specific topics covered in the print materials.

STI Monitoring and evaluation

With support from ACHAP and WHO, the Ministry of Health started the microbiological survey of commonly occurring sexually transmitted infections during the third quarter of 2007. The objectives of the survey were:

• To determine the prevalence of STIs in 3 sub-populations: sexually active women attending family planning clinics, sexually active men/women undergoing general pre-tertiary health screening.
• To determine the aetiology of the 3 major STI syndromes of urethral discharge, vaginal discharge and genital ulcers.
• To determine the antimicrobial susceptibility patterns of N. gonorrhoea isolates from men with symptomatic urethral discharge.
• To determine the appropriateness or otherwise of the currently recommended syndromic treatment for urethral discharge in men and for other STI syndromes in which N. gonorrhoea is commonly implicated.
• ACHAP procured reagents and drugs for this exercise as well as supporting the consultant working on this survey. This exercise was concluded in October 2008 and the final report is expected during the first quarter of 2009.