DefinePK

Abstract

Introduction


Most of the 340 million new infections with sexually transmitted infections (STIs) occur in developing countries.1 They contribute significantly to the burden of disease in these countries and some such as HIV are now considered the main developmental issue in some countries. While HIV or STI epidemics are nascent in Pakistan, global lessons suggest that this is the best time to control these epidemics. Control of such epidemics will require prevention of new infections and prompt treatment of current infections to avoid development of their reservoirs within communities.  Treatment of infections is only possible when those infected seek care. Since care is sought when symptoms are perceived to be due to these infections, understanding how these symptoms are perceived or care is sought is crucial to control of STIs. Additionally, those seeking care for STI symptoms may reduce their risky sexual behaviours following clinic attendance2 and their access to care providers is an opportunity to deliver prevention interventions. STI care seeking or provision and the effect of symptoms patients' care seeking behaviour are poorly understood in Pakistan. A 2001 study of 2400 women seeking antenatal care found that over 63% described at least one symptom that could have been due to an STI, and yet none of these women had sought care for it.3 Finally most resources for STI control and treatment are placed in the public sector. Yet over 70% of all healthcare spending in the country is in the private sector.4 Anecdotes suggest that majority of STI care is also found in the private sector and may even involve non-formal providers such as traditional healers. If these are verified, a major paradigm shift is needed in public health resources allocation for STI control.