Percent of STI patients receiving advice on condom use and partner notification and referral for HIV testing

Percent of STI patients receiving advice on condom use and partner notification and referral for HIV testing

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.

Data Requirement(s):

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

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