Control of Sexually Transmitted Infections, Reproductive Tract Infections, and HIV/AIDS in India: Current Status and the Way Forward

Abstract

Sexually transmitted infections (STIs) and reproductive tract infections (RTIs) form an important public health problem with a huge burden of disease and an adverse impact on reproductive health of people worldwide. Caused by a variety of infectious agents and manifesting as different clinical syndromes, STIs/RTIs remain highly prevalent in India too, reportedly up to 6% in general population (and maybe higher in reality due to secrecy maintained by many people around such diseases) and much more in certain vulnerable population groups. The situation has worsened further with the epidemic of human immunodeficiency virus (HIV) infection and resultant acquired immunodeficiency syndrome (AIDS). Similarities of unique host risk behaviors and socio-demographic factors associated with STIs, RTIs and HIV/AIDS call for an integrated approach for their control with multipronged intervention strategies. The National AIDS Control Programme, the National RTI/STI Control Programme, the National Strategy for Elimination of Parent-to-Child Transmission of Syphilis, the National Blood Policy, and other related health programs and policies have set out clear objectives and guiding principles for phased programmatic interventions, with focus on checking the spread of these infections through health education, behavior change, targeted interventions, early diagnosis, and prompt treatment. Freely available and easily accessible services for comprehensive care, support, and treatment of patients with these infections will help reduce the disease burden and improve their reproductive health as well as overall well-being. Increased decentralization of public health services; strengthening institutional capacities; setting up of designated STI/RTI clinics, antiretroviral treatment (ART) clinics and integrated counseling and testing centers; availability of rapid test kits, color-coded drug kits for syndromic treatment and ART treatment; promotion of condoms; integrated counseling and testing; partner notification; involvement of non-governmental organizations; community mobilization; universal precautions and augmentation of voluntary blood donation; robust surveillance; evidence-based planning, and effective program implementation are major components for control of these infections. The present systematic review discusses the current situation, the key programmatic measures, and the way forward for control of STIs/RTIs and HIV/AIDS in India

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