Health policies for controlling AIDS and STDs in developing countries

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Abstract
In developing countries the control and prevention of Sexually Transmitted Diseases (STDs) and the ensuing complications has received renewed attention since the emergence of the latest sexually transmitted disease, AIDS. Prevention via behavioural change has become more important than ever because of the current lack of therapy or vaccination for HIV infections. Considerations about STD and AIDS control programmes are discussed, and the option employed by the European Community to combine STD and AIDS control, is discussed. The strategies used for STD and AIDS control are health promotion and adequate management of patients with STDs. It is argued that health promotion should be targeted, and take into consideration priority activities and groups; that condom promotion should be an integral part of health promotion rather than being an autonomous activity; and that promotion of health seeking behaviour is an important part of the strategy. Adequate management of patients with STDs is effective for AIDS prevention because some STDs are associated with an increased risk of HIV transmission, but also because people coming spontaneously to a clinic can be considered a self-referred group, at an increased risk from HIV infection. The methodology used to implement those strategies is discussed, on three levels: the programming and management level; the expertise unit; and implementation at peripheral levels. Experiences, obstacles and technical problems encountered by the AIDS Task Force of the European Community are enumerated.

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