Measuring STI control
STIs are reliable markers of HIV transmission that should be monitored to assess effectiveness of combined prevention efforts. Feasible methods, based on case reporting and periodic surveys, can identify areas where STI control is poor and provide outcome data needed to monitor programme performance. Surveillance should be based on routine STI case reporting, supplemented with special surveys of STI and HIV prevalence, assessment of STI syndrome etiologies, antimicrobial resistance monitoring and risk behaviour prevalence. It is also important to monitor coverage of STI services, particularly for priority population groups.
STI surveillance is a recommended component of second-generation HIV surveillance. Trends of short-duration STIs are more sensitive indicators of high-risk sexual activity than those based on HIV prevalence and can be monitored widely, even in underserved areas where STI control is often poor. Yet few countries maintain systems to collect and use such data.27