STI in Guyana

 

A training session for STI technologists from six laboratory

sites in Guyana, as well as the University of Guyana

 

What are STI?

“STI” stands for sexually transmitted infections, which are infections or diseases that individuals contract through sexual activities, especially high-risk ones, such as having intercourse without a condom.  STI can have severe negative effects on the health of those who contract them, and can lead to infertility or even, in some cases, death.  There are several types of STI, including syphilis, genital herpes, gonorrhea, Chlamydia, and HIV/AIDS. 

    

STI in the world:

Data on STI are very hard to get, and prevalence studies are not regularly conducted in most countries, according to the WHO.  This might be due to the sheer number of STI, or to the fact that these are generally under-reported.  A fact sheet on Women and STI, issued by the WHO (http://www.who.int/mediacentre/factsheets/fs249/en/), says that women are much more vulnerable to these infections biologically, culturally, and socio-economically.  Many STI are asymptomatic in women, and, on top of this, many women do not seek treatment for STI because of the stigma attached to these diseases.      

 

STI in Guyana:

Infrastructure limitations prevent an accurate appreciation of the STI burden in Guyana; in 2002 there was only one dedicated treatment centre in the country, the Genito-Urinary Medicine (GUM) Clinic in Georgetown. CSIH’s initial assessment indicated that Guyana’s capacity to diagnose, treat and monitor STI cases was insufficient. Because of a significant lack of STI diagnostic capability, most conditions were being treated without a sufficient diagnostic assertion of the appropriate treatment.  Despite these limitations, the GUM Clinic was faced with a heavy burden: according to the Caribbean Epidemiology Centre, 42.7% of GUM Clinic patients were HIV-positive in 1997.  A 1998 study by the University of Miami revealed that one third of Georgetown’s sex workers were infected with syphilis.

For persons living outside the capital, distance represents an obstacle to getting tested and receiving treatment for STI. Those who can afford it have the option of turning to private laboratories, but a very large number of at-risk individuals will remain untested.

Epidemiologic studies demonstrate that a history of an STI is associated with an increased risk of HIV infection, presumably because the sexual behaviors that lead to STI increase the risk of acquiring HIV/AIDS. Furthermore, genital ulcerations and inflammation caused by STI have been implicated as cofactors for acquiring an HIV infection. Recent data suggest that in the presence of other STI, individuals are three to five times more likely to acquire HIV if exposed to the virus through sexual contact.

Expanding and strengthening the ability of the Guyanese health care system to prevent and manage STI cases is one of the Project’s main goals.   This includes strengthening the capacity of laboratories in the country to diagnose and treat these infections, and establishing National Guidelines for the institutional management of STI.  To date, the Project has accomplished the following:

•          A study to establish the baseline STI pathogens was completed in collaboration with CAREC and will allow for further refinement of guidelines

•          National STI strategy drafted and adopted 

•          Modules for STI management drafted and implemented at MOH Division of Health Sciences Education

•          STI diagnostic capacity strengthened, and regional clinic staffs have been trained in the treatment and diagnosis of STI

•          5 STI labs set up; the central lab has the ability to carry out cultures

•          STI laboratory network has been set up and linked to CAREC, where confirmation and drug sensitivity tests are carried out

•         For the first time, nurse-led management of STI cases is being implemented in Guyana, and the Project continues to assist in this aspect and mentor those involved

•         Over 100 lab technicians have been trained in the techniques of STI laboratory diagnosis

•         A core course at the University of Guyana on STI/HIV/AIDS/TB has been developed and is being delivered to both students and the general public

•         STI training programs run by the MOH Division of Health Sciences, which is responsible for training nurses, Medex and multi-purpose technicians, as well as for continuing education, have been upgraded with Project support

•         Health professionals, counselors and students in the four Project regions have received training and mentoring on STI

•         The Project has greatly enhanced the level of service delivery for STI clients in Guyana, and has developed surveillance forms to help the country manage these

•          Several STI-related lab manuals and curricula have been developed and are being used throughout Guyana as aids in diagnosing and treating these infections and in teaching students

 

Some Useful STI Links:

Calgary - Sexual and Reproductive Health

Calgary - STDs

Public Health Agency of Canada - Sexual Education

Teaching Sexual Health

Health Canada - STI

Public Health Agency of Canada - STD Self-Learning Module

 


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