Taking steps toward STD/HIV integration

The National Alliance of State and Territorial AIDS Directors and the National Coalition of STD Directors have published a report on STD/HIV integration that provides reasons for integration as well as steps that state and local jurisdictions can take to support integration.

The reasons include:

  • The same sexual behaviors that cause STDs also cause HIV. Prevention of HIV will benefit STD prevention, and prevention of STDs will benefit HIV prevention.
  • Recent studies have demonstrated that being infected with an STD may make it 2 to 23 times easier to transmit HIV, depending on the specific STD.
  • Many individuals infected with syphilis are also co-infected with HIV; nationwide, approximately 50% of men who have sex with men that have been diagnosed with syphilis were also HIV-positive.
  • By identifying those patients in clinics who are infected with both HIV and other STDs and then treating their STDs, we may be able to reduce new HIV infections by as much as 27%.
  • Because new HIV treatments have lessened the fear of becoming infected, behavioral interventions for HIV need to be augmented with biomedical interventions such as enhanced STD screening and treatment.

Steps for integration include:

  • Develop integrated surveillance systems, data collection, software, and analytic approaches for tracking and evaluation.
  • Develop behavioral surveillance and valid surveys and measures to address both HIV and STD issues (for example, behavioral and environmental factors).
  • Integrate surveillance activities to include case-based, venue-based and population-based systems, as well as to include disease, behaviors, and social factors.
  • Develop and disseminate STD screening and treatment guidelines to HIV and substance abuse providers to ensure familiarity and improve their ability to respond to patient concerns.
  • Consider developing STD advisory groups, in coordination with HIV community planning, to focus on prevention priorities and clinical treatment guidelines.
  • Cross-train STD/HIV staff in partner assistance and other services to help maximize resources and efficiency.
  • Integrate STD, HIV, and healthy sexuality curricula in schools.

Source: National Association of State and Territorial AIDS Directors, 2002.