Primary Care Public Health Nursing Service

Experience Sharing

The 9^th International Union against Sexually Transmitted Infections (IUSTI)

World Congress in Thailand

By

CHAN Ming-chu, Nursing Officer, Social Hygiene Service

The International Union against Sexually Transmitted Infections (IUSTI) is the oldest international organisation in the field (founded in 1923).  Its objective is to achieve international cooperation in the control of sexually transmitted Infections (STIs), including HIV infection. It concerns not only with the medical issues, but also the social and epidemiological aspects in the control of STIs, especially on HIV / AIDS.

The IUSTI World Congress is a biennial international occasion. The 9^th IUSTI was held in Bangkok, Thailand from 15 November 2005 to 18 November 2005. The theme was ¡§STI/HIV: Multidisciplinary Approaches ¡V East Meet West¡¨. The four-day congress consisted 6 plenary lectures, 17 symposiums, 3 special symposiums, 4 oral presentation sessions and poster presentations.

The congress was hosted by the Consortium of Thai Training Institutes for STDs and AIDS (COTTISA), the Thai Medical Society for the Study of STD (TMS-STD), the Department of Diseases Control, Ministry of Public Health, Thailand, and the Division of Reproductive Medicine, Department of OB-GYN, Faculty of Medicine, Prince of Songkla University. It was under the auspices of the International Union against Sexually Transmitted Infections (IUSTI) and its Asia Pacific Branch Committee. It was also supported by the World Health Organization, Regional Office for South-East Asia.

     There were plenty of up-to-date knowledge and experience sharings in the prevention and control of STIs / AIDS. Reviews showed that international migration, global political, economic and social changes have fueled the sexual mixing patterns across societies. Technological advances, such as Internet and sex toys, and medications to enhance sexual functioning, e.g. Viagra, further reinforced the expansion of recreational sex. These brought new challenges in the prevention of STI/AIDS globally.

Professor Frank Judson, the president of IUSTI, stated that accurate data collection played an important role in the prevention of STI /AIDS because ¡§we can¡¦t manage if we can¡¦t measure¡¨. His studies indicated that the incidence of STI has dropped by 80-95% since the emergence of HIV in the 1980s. The motivation for taking preventive measures was from the fear of AIDS. He mentioned that¡§ABC¡¨ (Abstinence, Be faithful, Condom use) should be stressed in the STI/HIV prevention. In addition, the HIV prevention paradigm should be shifted from ¡§to change the behaviour of the uninfected to avoid HIV exposure¡¨ to ¡§to change the behaviour of the infected to avoid exposing the uninfected¡¨.

The Human Papillomavirus Vaccine is another promising ray of light in STI prevention. It is rapidly being developed and is scheduled to be available in the market. However, studies indicated that barriers and ways of effective delivery of the vaccination programme have to be identified.

Relating to STI investigations, the use of rapid testings allowed patients to be treated at the time of clinic visits or in outreach settings without having them to return for test results and treatments. This breaks the chain of transmission, prevents complications and avoids delays in partner notifications. These testing methods are worth introducing to non-government organizations which are participating in STI/AIDS preventions.

             Thailand has launched the ¡¥100% condom use¡¦ programnme countrywide since 1991 and it has a dramatic impact on the prevalence of HIV and STI. Presently, the services they provide to sex workers include medical treatment, behavioural assessment, health education and contact tracing. The service pattern is similar to that provided in Hong Kong.

This congress was a valuable experience and learning opportunity. The representatives from countries in the East and West had brought up medical, social and epidemiological issues in the control of STI/AIDS. During the congress, participants interacted directly. There were research topics to which Hong Kong could make reference. Besides, it was also a good chance of networking with the medical professionals all over the world. To conclude, the prevention of STI/AIDS is a global matter. The success of its control requires international and multidisciplinary collaboration.

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