Health policies for controlling AIDS and STDs in developing countries

In developing countries the control and prevention of SexuallyTransmitted Diseases (STDs) and the ensuing complications hasreceived renewed attention since the emergence of the latestsexually transmitted disease, AIDS. Prevention via behaviouralchange has become more important than ever because of the currentlack of therapy or vaccination for HIV infections. Considerationsabout STD and AIDS control programmes are discussed, and theoption employed by the European Community to combine STD andAIDS control, is discussed. The strategies used for STD and AIDS control are health promotionand adequate management of patients with STDs. It is arguedthat health promotion should be targeted, and take into considerationpriority activities and groups; that condom promotion shouldbe an integral part of health promotion rather than being anautonomous activity; and that promotion of health seeking behaviouris an important part of the strategy. Adequate management of patients with STDs is effective for AIDSprevention because some STDs are associated with an increasedrisk of HIV transmission, but also because people coming spontaneouslyto a clinic can be considered a self-referred group, at an increasedrisk from HIV infection. The methodology used to implement thosestrategies is discussed, on three levels: the programming andmanagement level; the expertise unit; and implementation atperipheral levels. Experiences, obstacles and technical problemsencountered by the AIDS Task Force of the European Communityare enumerated.