By Mallah Tabot and Sylvia Ekponimo

In May 2024, The International Planned Parenthood Federation’s International Medical Advisory Panel (IMAP) released a statement on person-centered care for STIs. The statement  offers the most recent updates on sexually transmitted infections (STIs) and shares practical guidance for IPPF Member Associations (MAs) on “how to develop a comprehensive, person-centered approach for STI care” with emphasis on the importance of integrated services, adherence with guidelines, rights-based care, community involvement, advocacy, and a positive outlook on sexual health and well-being. As with other IMAP statements, this publication is very timely considering the global STI trends which are unfortunately on the rise, with more than 1 million curable STIs acquired every day and many countries continuing to report an increase number of cases.

Despite the deployment of interventions for the prevention, treatment, and management of STIs including HIV at global and regional levels, as well as the introduction of biomedical prevention technologies such as vaccines and pre-exposure prophylaxis (PrEP) for HIV prevention, the situation remains bleak. In 2020, global data indicated an estimated 374 million new STI cases per year, with 26% of the new cases coming from Africa. For HIV prevention, PrEP services are expanding significantly in Africa, with 22 countries offering it to adolescent girls and young women, sex workers, gay and other men who have sex with men, transgender individuals, people who inject drugs, and/or prisoners. While its benefits have been widely documented, with the latest research revealing that PrEP reduces the risk of getting HIV from sex by 99%, it however does not prevent against other STIs or pregnancy.

Strategies and planning frameworks for the integration of HIV and other STIs in the face of this global surge exist. However, the elements required for intentional implementation may be missing especially in low resource settings which in turn limits our collective ability to overturn this trend and improve efficiency within our health systems. Currently, most PrEP interventions are implemented within HIV programmes with significant focus on priority population groups. While this is plausible as these populations are at-risk and most-often underserved, pertinent questions however remain, which we must continually reflect upon and consider – Have we fully harnessed valuable opportunities to integrate and link STI service delivery to other services including HIV? How can we ensure that current STI interventions truly contribute to reverse the trends of STI prevalence in Africa? Is the expansion in access to PrEP services in Africa an opportunity to do so? With the rollout of multiple PrEP methods that protect against HIV without condom use, are we fully integrating services?

A systematic review of some studies on STI prevalence amongst PrEP users highlights the need for active integration of HIV and STI services especially for key populations. Therefore, a critical interrogation into current implementation strategies for STI management vis-a-vis PrEP programming is essential.

With this in mind, it is of the essence for MAs and other partners to take heed of the robust and actionable recommendations in this IMAP statement, and reevaluate their STI/HIV integration strategies. From standard operating procedures that ensure that clients are systematically offered testing for HIV and STIs, no matter the reason they are attending the clinic, to provider training on integrated services, or checklists to ensure these tests are offered and conducted, we must ensure that strategies are tailored to overturn the current STI prevalence while sustaining efforts in HIV prevention through PrEP.