At the 23rd World Congress of the International Union against Sexually Transmitted Infections (IUSTI) WHO released a new module of its implementation tool for HIV pre-exposure prophylaxis (PrEP) to support countries implementing, and scaling up integrated STI services for people who use PrEP. The module provides a framework and practical guidance for decision-makers, programme and facility managers, and health care workers for the gradual integration of sexually transmitted infection (STIs) services considering the local context and modes of PrEP delivery services.
People who would benefit from PrEP for HIV infection are also often at high risk of another STIs. Globally, 1 in every 4 persons who would benefit from HIV PrEP have been diagnosed previously with at least 1 STI – namely gonorrhoea, syphilis or chlamydia before starting PrEP.
Since STIs are asymptomatic, many of these infections would have been missed and the chain of transmission would have continued if testing had not occurred. Considering that many STIs are easily cured, offering STI services for people on PrEP is an opportunity that should not be missed. Recently, WHO has conducted a review of national guidance documents for HIV PrEP and found that one third did not mention STIs as part of their PrEP-related recommendations.
“Offering STI services for people who use PrEP creates an opportunity to reach those at higher risk of infection who might otherwise remain undiagnosed, particularly as most STIs do not present signs or symptoms,” said Teodora Wi, lead of WHO’s Global STIs Programme. “This approach is beneficial for the person with an STI, their sexual partners and also for the STI response,” she added.
“Service integration at the primary level of care creates efficiencies and synergies for the health system and promotes a people-centred approach to improve people’s sexual health and their quality of care,” said Meg Doherty, Director of WHO’s Global HIV, Hepatitis and STIs Programmes. “We hope that this new guidance will contribute to these goals.”
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