Control of Sexually Transmitted and Reproductive Tract Infections, and HIV/AIDS

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Each year some 500 million new cases of syphilis, gonorrhoea, chlamydia and trichomoniasis occur in men and women; overall, STI prevalence rates continue to rise in most countries.

The majority of HIV infections are sexually transmitted or associated with pregnancy, childbirth and breastfeeding. The interactions between sexual and reproductive health and HIV/AIDS are now widely recognized. In addition, sexual and reproductive ill-health and HIV/AIDS share root causes, including poverty, gender inequality and social marginalization of the most vulnerable populations.

Unsafe or unprotected sex increases a person’s chances of contracting HIV, other sexually transmitted infections and unwanted pregnancy.

Of the 2.7 million new HIV infections worldwide in 2010, 70% (1.9 million) were in sub-Saharan Africa. Most newly infected people in this region acquire the virus during unprotected heterosexual intercourse. The prevalence of HIV infection among young women in sub-Saharan Africa is disproportionately higher than among young men.

In 2010, 71% of people living with HIV aged 15–24 years were women and one quarter of all new HIV infections globally were in young women aged 15–24 years.

This is attributed to women having a sexual debut earlier than men, and fewer numbers using condoms than men (42% versus 63.6%) during the sexual act, sexual violence against women and girls and biological factors. In addition, adolescent girls have an increased risk because they are often married to older partners, who are more likely to have been exposed to HIV. For example in one study, the husbands of adolescent girls were found to have HIV 30% of the time, while the male peers of these girls had only a 12% HIV rate.

Several other infections result from risky sexual behaviour. HPV, which is responsible for almost all cervical cancer, is sexually transmitted.

Cervical cancer is the leading cause of cancer deaths in the Region. Other sexually transmitted infections such as syphilis, gonorrhoea and chlamydia are entirely attributable to unsafe sex, and still occur in several African countries.

Interventions

The main objective in this area is to provide guidance on strategies for controlling sexually transmitted infections (STIs) and reproductive tract infections (RTIs), including strategies to prevent mother-to-child transmission of HIV and other STIs and to improve strategies for the integration of RH and HIV/AIDS. The following outcomes are expected:

  • improved access to, and uptake of key HIV/AIDS and SRH services, better access of people living with HIV/AIDS (PLWHA) to SRH services tailored to their needs,
  • improved coverage of underserved and marginalized populations, such as injecting drug users, sex workers or men who have sex with men, with SRH services,
  • greater support for dual protection against unintended pregnancy and sexually transmitted infections (STIs), including HIV, for those in need, especially young people,
  • improved quality of care and enhanced programme effectiveness and efficiency.