[From the apprehension of sexually transmissible diseases to the prevention of HIV].
Over the past few years in France, the incidence of human immunodeficiency virus (HIV) has not decreased. Among the most frequent sexually transmissible diseases (STD) in France (condyloma, genitoanal herpes, chlamydia infections), certain STD, considered as negligible, have reappeared: gonorrhoea and syphilis affect male homosexuals and, to a lesser degree, men and women whose epidemiological profile remains to be determined. The health organization is not in favour of associating STD with HIV in its anti-aids strategy. However, acute STD are not only indicator of habits at risk for HIV, but are also potent co-factors of its sexual transmission. Fighting against HIV without creating a dialogue on STD is a waste of time and efficiency. From our experience with the STD, anonymous and free screening and the inter-disciplinary health education centres, we recommend the following: improved screening for HIV and other STD: concomitantly whenever possible, less invasive, free or reimbursed STD sampling, reliable and standardized techniques (polymerisation chain reaction or PCR and derivatives), itinerant screening for STD for persons who do not consult; ensured early, medical, social and psychological care of HIV and STD, emphasising the importance of compliance to treatment and prevention; ensured easy access and low cost of the male and female condoms; renewal and diversification of health relays, particularly in the private sector; staff training on STD and their epidemiological novelty; insisting on a transversal (HIV-other STD, curative-preventive, among others) and pragmatic approach (intervention studies resulting in local action); renewal of the information and advice for the public: information on the relationship between HIV and other STD, on the frequent STD that are lesser known, such as condyloma and chlamydia infections, emphasis on compliance to prevention measures (abstinence or use of condoms) during at least three months after a risk of HIV/STD transmission or after an STD has been identified and treated. The aim is to enhance the acceptation or the appropriation by the public of concomitant STD/HIV screening, prevention measures and treatments proposed. This can only be implemented after a change in the institutions', carers and public's attitude towards STD.
Deniaud
F
F
Centre MST, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, F 75475 París.
Melman
C
C
D017280:Condoms; D005602:France; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D008403:Mass Screening; D010353:Patient Education as Topic; D011634:Public Health; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000517:prevention & control*
De l'appréhension des maladies sexuellement transmissibles à la prévention du VIH.