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Q. 1 Why no reduction has been noticed in the prevalence of Sexually Transmitted Infections in India even though the STD Control Programme has been in operation since 1949 ? Which activities are provided under STD Control Programmes?
Ans. Precise data about the prevalence of STIs in India is not available. However, from the limited number of studies conducted among the ‘High Risk Population’ or ‘Hospital Based Studies’, prevalence rate of STIs in has been quoted to be about five percent. Now, NACO has planned to ascertain the prevalence of STIs and also health seeking behaviour of persons suffering from this group of diseases by undertaking a country wide community based STI Prevalence Survey. STD Control Programme is based on early diagnosis and prompt treatment of STIs and relies on the health seeking behaviour of individuals with STD. Health seeking behaviour of those suffering from STDs is directly related to the stigma attached to the disease, because of which individuals with STI desire anonymity. As a result, they seek alternate source of medical aid including self-medication and only a small proportion report to public sector medical set-up. Because of this attitude and behaviour of those suffering from STIs, they continue to transmit infection to their multiple sex partners. This is the main obstacle in converting infectious pool into non- infectious. Under the STD Control Programme, the government has established STD clinics in each district hospital, all over the country. The STI drugs are provided free of cost by the Government of India and adequate confidentiality is ensured for those attending these clinics. Such clinics are managed by experts trained to treat STIs. Another major activity of STD Control Programme is Targeted Intervention under which, special facilities are made available easily to commercial sex workers, truckers, migrant workers and other marginalised segments of society. Partner notification, condom promotion and imparting IEC activities through peer-educators are the interventions organised as a part of the programme. STI management through syndromic approach has been now practiced by trained medical officers at peripheral, middle and even at tertiary levels of healthcare where adequate lab facilities are not available.