Improving Access to STD Care

- STD Syndromic Management is perfectly adapted to primary health care settings.

In many developing countries, a syndromic approach for the management of patients with STDs is currently being used, resulting in well accepted, quality STD care in primary health care settings. Because it is simple, rapid and does not require sophisticated laboratory tests, the syndromic approach makes it possible for almost every health care worker to offer prompt diagnosis and treatment to patients with STD symptoms.

- Research findings from several countries confirm that many people seek STD treatment outside the formal medical system.

Although high levels of self-treatment and limited resources for STD control in many countries compel policymakers, medical professionals and donors to consider innovative approaches to improving access to effective treatment, opposition to providing STD management outside the clinic setting is strong. Training pharmacists and other drugstore personnel in the syndromic approach can improve the management of STDs in many patients who choose to self medicate.

- The achievements of an STD control program depend to a large extent on the successful management of STDs at a patient's point of first encounter with the health care system.

Genital ulcers in men and women and urethritis in men can be adequately managed using a syndromic approach based on symptoms and clinical signs only. For lower genital tract syndrome in women, the concept of adding a risk score to the syndromic management holds promise as a more sensitive way to detect cervicitis. Ongoing validation and acceptability studies will further demonstrate the advantages of this approach compared with the classical clinical (etiologic) approach.

- Drug availability is the most essential component of the clinical management of STDs.

Without a consistent drug supply, patients cannot be treated appropriately, and lapses in the supply cause the community to lose confidence in the system which leads to poor care seeking behavior.