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Hawkes, Sarah and K.G. Santhya
Diverse Realities: Understanding Sexually Transmitted Infections and HIV in India
South and East Asia Regional Working Paper Series
The Population Council, New Delhi, 2001, 77 pp

"Paper presented at the meeting on 'Phase-specific Strategies for the Prevention, Control and Elimination of Sexually Transmitted Diseases'. Rome, October 3-6, 2000." Reproduced with kind permission of the Population Council.


"Sexually transmitted infections (STIs), including HIV, currently have high salience on the health care agendas of many countries, including India. Strategies for their control are ideally based on a number of well-recognised principles. These include: assessments of the burden of disease; the availability of interventions at policy and programme levels, to influence behaviour change and technical solutions; and the calculated cost-effectiveness of these interventions. In the case of India, data to inform these principles are often lacking in the case of STI control. In this paper we have reviewed the evidence base for STI control in the Indian context. The paper is split into a number of sections: a review of the socio-demographic and structural level factors which may indicate vulnerability to epidemics of the sexually transmitted infections; a compilation of the available evidence on the prevalence and epidemiology of these infections; individual level risk factors for infection; responses to risk and infection both at the individual level and within the
pluralistic health service; and a detailed review of the STI/HIV control programme in the country. We conclude with a summary of the evidence base and make suggestions for areas where further work is needed to strengthen this base."

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