Global Sexually Transmitted Infections Programme
The Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes leads the development and implementation of the global health sector strategy on the elimination of sexually transmitted infections as a public health threats.
Prevention
Barrier methods
When used correctly and consistently, condoms offer one of the most effective methods of protection against sexually transmitted infections (STIs), including HIV. Female condoms are effective and safe, but are not as widely used by national programmes as male condoms.
Counselling and behavioural approaches
Counselling and behavioural interventions offer primary prevention against STIs (including HIV), as well as unintended pregnancies. These include:
- comprehensive sexuality education
- STI and HIV pre-test information and post-test counselling
- safer sex/risk-reduction counselling
- condom promotion
- evidence-based behavioural interventions with a focus on key populations: sex workers, men who have sex with men, transgender people, persons in prisons and people who inject drugs; and
- education and counselling tailored to the needs of adolescents.
In addition, counselling can improve people’s ability to recognize the symptoms of STIs and increase the likelihood that they will seek care and encourage a sexual partner to do so. Unfortunately, lack of public awareness, lack of training among health workers, and long-standing, widespread stigma around STIs remain barriers to greater and more effective use of these interventions.
Despite considerable efforts to identify simple interventions to reduce risky sexual behaviours, behaviour change remains a complex challenge. Research has demonstrated the need to focus on carefully defined populations, to consult extensively with the target population identified, and to involve them in the design, implementation and evaluation of interventions.
Vaccines and other biomedical interventions
Safe and highly effective vaccines are available for 2 STIs: hepatitis B virus and HPV. These vaccines represent major advances in STI prevention.
Research to develop vaccines against herpes simplex virus and HIV is advanced. Studies suggest that vaccines against serogroup B Neisseria meningitidis (MenB) could provide some protection against gonorrhoea. Randomized controlled trials with MenB vaccines to prevent gonorrhoea are underway, and several other gonococcal vaccine candidates are in preclinical development. Research studies into vaccines for chlamydia, syphilis and trichomoniasis are in earlier stages of development.
Other biomedical interventions to prevent some STIs include voluntary medical male circumcision (VMMC) and microbicides.
- VMMC reduces the risk of heterosexually acquired HIV infection in men by approximately 60% and provides some protection against other STIs, such as herpes and HPV.
- Tenofovir gel, when used as a vaginal microbicide, has had mixed results in terms of its ability to prevent HIV acquisition. It has shown some effectiveness in preventing herpes simplex virus type 2.