Jayapalan Sabeena
Department of Dermatology and Venereology, Government Medical College, Thiruvananthapuram, Kerala, India.
Indian J Sex Transm Dis AIDS. 2016 Jul-Dec;37(2):157-161. doi: 10.4103/0253-7184.188483.
Sexually transmitted infections (STIs) are a major public health problem in developing countries. These diseases are associated with increased risk of transmission of human immunodeficiency virus as well as adverse outcomes on pregnancy and reproductive health. Sexual behavior and healthcare-seeking behavior are identified as the true risk factors of STIs.
Hospital-based cross-sectional study design was adopted. Eighty-five STI patients were studied regarding the inappropriate treatment-seeking behavior, the nature of the first point of contact with the health care, the appropriateness of treatment and the concerns of the patient regarding the services rendered by government health-care facilities.
Among the 85 patients studied, 55.3% were males and 44.7% were females. Inappropriate treatment-seeking behavior was seen in 29.8% of males and 36.8% of females. About 59.6% of males and 81.6% of females sought appropriate treatment from modern medicine practitioners before attending our institution. Only 7.1% of males and 3.2% of females received appropriate treatment. The government sector was the choice of treatment for 46.4% males and 93.5% females and this difference was statistically significant ( = 0.00081). Lack of free medicines, issues of confidentiality, and privacy were the major service-related issues in the public sector.
Appropriate treatment at the first point of contact with the health system is an important measure to prevent further transmission and development of complications. Health providers from both private and public sector should be given frequent periodic training regarding syndromic management of STIs and the training should stress on the need for risk reduction and condom promotion messages along with medical management. Program planners should take necessary steps to ensure adequate and continuous supply of free drugs and tackle issues of confidentiality and privacy.
性传播感染（STIs）是发展中国家的一个主要公共卫生问题。这些疾病与人类免疫缺陷病毒传播风险增加以及妊娠和生殖健康方面的不良后果相关。性行为和就医行为被确定为性传播感染的真正风险因素。
采用基于医院的横断面研究设计。对85例性传播感染患者就不适当的就医行为、与医疗保健的首次接触性质、治疗的适当性以及患者对政府医疗机构提供服务的关注进行了研究。
在研究的85例患者中，55.3%为男性，44.7%为女性。29.8%的男性和36.8%的女性存在不适当的就医行为。在到我们机构就诊之前，约59.6%的男性和81.6%的女性向现代医学从业者寻求了适当治疗。只有7.1%的男性和3.2%的女性接受了适当治疗。46.4%的男性和93.5%的女性选择政府部门进行治疗，这种差异具有统计学意义（P = 0.00081）。免费药品短缺、保密和隐私问题是公共部门主要的与服务相关的问题。
在与卫生系统首次接触时进行适当治疗是预防进一步传播和并发症发展的重要措施。应定期对私立和公立部门的卫生服务提供者进行性传播感染综合征管理方面的培训，培训应强调降低风险和推广避孕套信息以及医疗管理的必要性。项目规划者应采取必要措施确保免费药品的充足和持续供应，并解决保密和隐私问题。
