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World Health Organization, "Periodic Presumptive Treatment for Sexually Transmitted Infections"

This publication summarizes the deliberations of the technical consultation, which covered current knowledge on periodic presumptive treatment and experiences to date with interventions, including the conditions that seem to be the most favourable for such interventions to work well. Further research is clearly needed in this field – including research employing possible modelling with current field data. Recommendations for research, as well as guidelines for those carrying out programmes with periodic presumptive treatment, were formulated and are presented in the final section of this publication.

Contents:

Abbreviations i

Acknowledgements ii

Executive summary iii

1. Introduction 1

2. Objectives 2

3. Participants and methodology 2

4. What is periodic presumptive treatment? 3

4.1 Definitions 3

4.2 A continuum of approaches 3

5. Sex worker populations 4

6. Experiences of one-time presumptive treatment for STIs among core groups 4

Angeles City, Philippines 4

Antananarivo and Tamamave, Madagascar 4

Sihanoukville, Cambodia 5

7. Experiences of periodic presumptive treatment for STIs among core groups 6

7.1 Periodic presumptive treatment within the context of existing STI services 6

South African mining communities 6

Conclusions 7

Hillbrow sex worker intervention, Johannesburg, South Africa 7

Conclusions 8

Nairobi, Kenya 8

Conclusions 8

Cotonou and Porto-Novo, Benin and Accra, Ghana 9

Conclusions 10

Mysore, India 10

Conclusions 11

7.2 Periodic presumptive treatment outside of routine STI services 11

The Lao People’s Democratic Republic 11

Conclusion 12

8. Conclusions, recommendations and priorities for further research 13

8.1 Uses of presumptive treatment and periodic presumptive treatment for STI control 13

One-time presumptive treatment 13

Periodic presumptive treatment 13

8.2 Approaches to operating periodic presumptive treatment 13

8.3 Evaluation of the effectiveness of periodic presumptive treatment 14

Effectiveness 14

Cost-effectiveness 14

Mobility 15

8.4 The impact of periodic presumptive treatment on specific STIs 15

Coverage of specific STIs 15

Chancroid 15

Trichomoniasis 15

Genital herpes 15

HIV transmission 15

8.5 Operating periodic presumptive treatment programmes 16

Periodicity, tapering and the duration of programmes 16

Inclusiveness 16

Training 16

8.6 Drug resistance 16

8.7 Uses of modelling 17

Annex 1. References 18

Annex 2. List of participants 19

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