Current approach to STD management in women

HIV infection was recognized as a new sexually transmitted disease (STD) at the beginning of the last decade. The knowledge of risk factors for sexual transmission of HIV changed the focus on STD to a broader perspective for prevention and control of HIV infection, and consequently of STD. Barriers to STD control include cultural aspects, difficulties in changing sexual be havior, asymptomatic disease in women and expensive and inaccessible tests for diagnosis. The classical clinical approach based on etiologic treatment has never been achieved by developing countries. The international communi ty has been searching for new approaches. Syndromic management and mass tre atment are strategies recently found as useful. Nevertheless the best appro ach to endocervicitis by Neisseria gonorrhoeae and Chlamydia trachomatis re main problematic. Then, the current approach to STD management must include : prompt attention to every patient seeking care for STD; early diagnosis a nd treatment; delivery of short term treatment at the clinic; education on STD/HIV; screening for other STDs with pre- and post-test counseling; couns eling on risk reduction; provision of condones; integration of STD services with family planning, prenatal and gynecological services. (C) 1998 Intern ational Federations of Gynecology and Obstetrics.