Percent of STI patients receiving advice on condom use and partner notification and referral for HIV testing
The percent of patients with sexually transmitted infections (STIs) who are given advice on condom use and partner notification and referred for HIV testing
Previous indicators only included the first two elements of this indicator. A health care provider must score positively on both condom advice and partner notification advice for the client to enter the numerator for this indicator. The current indicator includes a third element: referral for voluntary testing for HIV. However, if national policy does not include referring STI patients for HIV counseling and testing, or if voluntary counseling and testing services are unavailable and not actively promoted by national AIDS and STI programs, the indicator should exclude referral for counseling and voluntary HIV testing. Health facility surveys through direct observation of interaction between care providers and clients yield data for this indicator.
This indicator is calculated as:
(Number of patients with STIs given advice on condom use and partner notification and referred for HIV testing / Total number of patients with STIs) x 100
The evaluator should report different components of this indicator separately, for reasons given below.
Assessment by an external expert
WHO/UNAIDS revised guidelines on evaluating STI services; MEASURE Service Provision Assessment (SPA)
By promoting condom use and by encouraging the treatment of partners to avoid reinfection, STI services seek to prevent the recurrence of STIs, not just to treat them. Increasingly, STI care serves as an entry point for referral for voluntary testing for HIV. This indicator measures the extent to which these aspects of STI service provision are functioning.
If a client is at an STI clinic, previous efforts to promote safe behavior have failed him or her. This measure does not evaluate the success of prevention initiatives, merely the extent to which service providers are complying with standards.
The extent to which the direct observation methodology biases data has caused concern because researchers assume that service providers perform better under observation than they normally would. Also, it is suggested that exit interviews with clients may be a more cost-effective method than observed interactions in compiling this indicator. However, clients may misreport the actual content of counseling. Further research is needed to determine the reliability of exit interviews in collecting data for this indicator.
Condom promotion, advice on partner referral, and referral for HIV testing are in fact quite distinct activities. The value of an aggregate indicator in this field is therefore somewhat limited, at least to program staff. In addition, referral to HIV testing services will depend upon the availability of those services locally. And the addition of this component will disrupt trends over time in those countries where a different indicator has been calculated in the past. For these reasons, the evaluator must take special care to report separately the three elements of this indicator.
sexually transmitted infection (STI), management, quality, HIV/AIDS, commodity