title: Service delivery through public health care system to control sexually transmitted infections in Himachal pradesh.
abstract: BACKGROUND
  The National AIDS Control Organization has designed multiple synergistic interventions to identify and control curable sexually transmitted infections (STIs).
  
  
  OBJECTIVE
  To assess the impact of services offered at designated STI clinics in the state of Himachal Pradesh, India and the profile of the attending clients.
  
  
  METHODS
  This was a two-year prospective study, conducted from April 2011 to March 2013. Training on delivering STI/RTI services was imparted to the staff of 16 designated STI clinics including recording of data. The staff in each STI clinic comprises of one doctor, one counselor, one nurse, and one laboratory technician. The clients attending these designated clinics were offered counseling, syndromic case management (SCM), and diagnostic services wherever possible. Monthly data of STI clinic attendees was collected, compiled, and analyzed.
  
  
  RESULTS
  A total of 65,760 clinic visits were reported, of which 32,385 (49%) visits were for index STI/RTI complaint(s). The ratio of male to female attendees was 1:2. The commonest age group accessing the STI clinics was 25-44 years (n = 38,966; 59.3%). According to SCM, 52.9% clients were managed. The commonest presenting syndrome was urethral discharge (n = 4,500; 41%) in males, and vaginal discharge (n = 13,305; 56%) in females. Genital ulcer disease was treated in 2099 cases. Laboratory tests were performed only in 6466 patients, and 39,597 antenatal mothers were screened for syphilis. Counseling services were provided to 51,298 (f = 34,804; 68%: m = 16,494; 32%) clients and of these, 48% (n = 25,056) of the clients were referred to integrated counseling and testing centers. Forty-three clients (m = 24: f = 19) were detected positive for HIV infection.
  
  
  CONCLUSIONS
  Uniform and standardized services delivered to clients attending public health clinics can gather reliable data to monitor trends of STI infection.
authors.affiliation: Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Sunite A
authors.initials: SA
authors.lastname: Ganju
authors.affiliation: Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Kanga
authors.affiliation: Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Suruchi
authors.initials: S
authors.lastname: Bhagra
authors.affiliation: Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Ramesh C
authors.initials: RC
authors.lastname: Guleria
authors.affiliation: Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Dig Vijay
authors.initials: DV
authors.lastname: Singh
authors.affiliation: Himachal Pradesh State AIDS Control Society, Shimla, Himachal Pradesh, India.
authors.forename: Vinay
authors.initials: V
authors.lastname: Agnihotri
authors.affiliation: Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Santwana
authors.initials: S
authors.lastname: Verma
keywords: Counseling; sexually transmitted infections; syndromic case management