STIs integration into HIV services critical – Guyana Strategic Plan

The integration of sexually transmitted infections (STIs) into HIV services is critical to the prevention and spread of STIs in Guyana. This is according to the Guyana STI Strategic Plan 2011- 2020.

The similarities of the two can be seen through the means of transmission; (behavioural patterns) and, more importantly, the methods of prevention are the same. Unfortunately, more emphasis is placed on HIV information and treatment, resulting in almost total neglect of STIs.

The Guyana Sexually Transmitted Infections Strategic Plan 2011- 2020 has emphasised the importance of having a collaborative approach in tackling both HIV and STIs. According to the strategic plan, STI/HIV integration can occur at varying levels and can prove very successful.

“At the policy level, HIV/AIDS policies that have been formulated can be amended to include other STIs. At the level of service delivery, there needs to be an integrated curriculum for in- service training and continued learning activities for HIV. Such case discussions need to incorporate the other STIs,” the plan stated.

Health Minister Dr Leslie Ramsammy believes that having a combined approach to STIs and HIV will allow for cross-training of health workers. This, he said, will see health care professionals being better able to provide better quality care to those suffering from the diseases.

“However, in order for this to be achieved, key health system components need to be aligned, including procurement and supply management systems,” the strategic plan for 2011-2020 outlined.

STIs prove to be major health problems, and building on existing programmes is the key to addressing the issue of the spread of STIs.

“There is significant potential to build on existing programmes such as the Tuberculosis, Maternal and Child Health, and Sexual and Reproductive Health Services.” Suggestions have been made to create links between STIs and other diseases by incorporating STIs into tuberculosis outreaches; expanding the routine screening of pregnant women to include other STIs, such as gonorrhea, chlamydia and hepatitis B. That aside, STI prevention, care and treatment services have to be integrated into the primary health care system, so that persons across the country can benefit from those services.

According to the plan, “Health system strengthening is integral to the process of expanding access to high quality, comprehensive STI prevention, diagnostic, and care and treatment services.” However, it is also imperative that the relevant institutions focus on improving laboratory capacity across the country, so that all health care facilities would be equipped with the know-how to conduct all tests.

It therefore means that training must be increased in that regard, so that every health care provider would be in a better position to conduct testing and provide core information to the infected and affected. “The relevant policies, protocols, standards and guidelines need to be reviewed as appropriate; and systems need to be in place to ensure that health facilities have the required resources (human, infrastructural, materials and equipment) to provide STI services…” There also continues to be a need for the monitoring of STI prevalence to be strengthened, making statistics widely available for evidence- based programme planning and decision making.

“STI research needs to be ongoing to facilitate increased understanding of the local context, as well as to identify populations for targeted interventions and to assess the impact of such interventions. This includes surveillance for antimicrobial resistance to guide treatment regimen changes, and information on STI prevalence, knowledge, behaviours and health-seeking behaviours.” The plan recommended.

Like HIV/AIDS, STI services need to be provided in an environment that is free from stigma and discrimination, where those infected can feel comfortable and have their rights respected and protected. In this regard, there needs to be more public awareness. In-school dissemination of information is also critical to the process.

The strategic plan would be implemented over a ten-year period, but funding is critical to the attainment of the goals deemed achievable during this period. It is believed that while funding for STI programmes have been limited in the past, there is scope for funding to be provided alongside HIV. It is hoped that adequate resources would be made available through partnerships, so that the issue of STI prevention, treatment, care and awareness could be taken to a higher level.

In 2009 and 2010, it had been reported that more females than males were infected with STIs. In 2009, data from the National Treatment and Care Centre (NTC) suggested that 380 or 45.2 per cent males were infected, while 460 or 54.8 per cent females contracted STIs. In 2010, there proved a slight decline in the number of men infected. There were 326 men, representing 44.4 per cent of the sample; while the statistics for women represented an increase, as 55.6 per cent of the women tested were infected.