Number of people who received sexually transmitted infection screening and treatment

How to use this indicator

Countries that have managed to successfully control sexually transmitted infections have experienced reversals or reductions in their HIV epidemics. Sexually transmitted infection (STI) services should target and provide outreach to populations of highest risk, promote and provide condoms, and provide case management of STIs for people and their partners. Programs usually treat STIs and prevent their recurrence by promoting condom use and encouraging partners to be tested and treated to avoid reinfection. Provision of clinical services in health facilities alone has proven inadequate to control STIs, because many people do not go to clinics. Continuous access to STI services has been shown to reduce HIV transmission, making outreach and community-based STI services very important. STI care is also seen as an entry point for HIV testing, which is important because patients suffering from STIs may have acute HIV infection, given the increased risk of HIV transmission STI imparts. This indicator provides insight into the reach of HIV programs to provide functional STI screening and treatment services. It tracks the uptake and use of services as well as whether those tested and identified as positive for an STI have actually received treatment. Community and outreach workers are essential for effective targeting of key populations and bridge populations by identifying locations of higher STI prevalence and mapping them.

To ensure quality of care, all people regardless of HIV status or key population status should receive STI treatment if diagnosed. However, this indicator also tracks provision of both STI testing and treatment services among those who test HIV-positive. Infants may be at risk of STIs in the event of mother-to-child transmission during delivery as well as children who are exposed to sexual exploitation and/or violence. Vulnerable children who are exposed to HIV may also be at heightened risk for acquiring STIs because of earlier sexual debut and sexual risk-taking behaviors. Adolescents who benefit from HIV-prevention programs should also receive STI testing and treatment services, especially if they are sexually active.

Numerator

Number of adults and children who were tested for any STI and were treated for an STI during the reporting period

Unit of measure

Number

Calculation

Sum results across reporting period

Method of measurement

Data for the indicator should be determined by counting the total number of adults and children who received STI testing and treatment services, regardless of testing source (facility or community levels). Community workers can ask beneficiaries this question to determine whether the beneficiaries have been tested and the location of testing within a certain time frame, regardless of whether testing occurred at the facility or community level. However, the service delivery modalities that apply specifically to the community level are listed below. A community worker can track community-based testing specifically by recording the number of people tested in locations other than facilities.

Community-based service delivery modalities:

  • Mobile testing: temporary testing locations excluding voluntary medical male circumcision
  • VCT: drop-in center, wellness clinic where STI testing is provided, or site designated for key populations
  • Other community platforms: ad hoc testing campaign

This indicator specifically tracks STI testing and treatment from any source. It does not track STI status. A project beneficiary who has received STI testing, as well as treatment, regardless of source, should be counted towards this indicator.

A mandate to do no harm must be the absolute priority whenever community programs engage in data collection and reporting of STI status. All data must be managed with confidentiality to ensure that the identities of people living with STIs (and their key population status as applicable) are protected, to prevent stigma and discrimination. Community workers should engage with utmost caution in collecting, managing, and reporting this information and ensure confidentiality of files.

Data source

This indicator is often found in peer outreach forms and behavior change communication forms for key population programs.

Disaggregation

  • Age (<1 year, 1–4 years, 5–9 years, 10–14 years, and 15–19 years for children; 20–24 years, 25–49 years, and 50+ years for adults)
  • Sex
  • Pregnancy/lactation status
  • Key population type (sex workers, transgender people, men who have sex with men, people who inject drugs)
  • Service delivery modality
  • Type of STI
  • Partner type (one time paying, regular paying and non-paying)

Disaggregation should be based on whether the person tested occupies one of the key population categories. If a person occupies more than one category, this information should be reported by the community health or outreach worker. Given the sensitivity of this information, and the possible ramifications of disclosure for people who occupy these categories, community workers should engage with utmost caution in collecting, managing, and reporting this information. Community workers should also keep the files secure, to ensure confidentiality and to ensure that they do no harm.

Data quality considerations

The overall number reported for this indicator should be equal to the sum of people in each disaggregation type. Use one type of age disaggregation throughout is recommended; overlap should be avoided. Service delivery modalities should be mutually exclusive. It is important to pay attention to the reporting period to avoid double counting of people (quarterly versus annual reporting). People who have been tested should only be counted once within the allotted time frame, though some may have been tested and treated numerous times or tracked by both facility and community workers. This indicator does not track the number of people who have a STI, because some people, especially those at higher risk, may have been screened and treated for more than one STI during the reporting period, or may not have accessed testing and treatment services. This indicator also does not include HIV, because although HIV can be transmitted sexually, it can also be transmitted through other modalities and should be tracked distinctly. The number of tests administered should not be counted towards this indicator, but rather the number of people tested.

Reporting frequency

Community workers should collect this information regularly but monitor progress monthly with support from their supervisors. The indicator should be reported on a semiannual basis.

Data element

STI diagnosis and treatment

Category

Vulnerable Children, Key Populations, HIV Prevention

References

Centers for Disease Control and Prevention (1998). STD treatment to prevent HIV Infection: Implications of recent community-level studies. Retrieved from https://www.cdc.gov/std/hiv/facts_treatment_prevent_hiv_infection.htm

Steen, R., Wi, T. E., Kamali, A., & Ndowa, F. (2009). Control of sexually transmitted infections and prevention of HIV transmission: Mending a fractured paradigm. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770276/

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