effective therapy. However, as documented in Chapter 5, there is limited awareness of, and compliance with, these guidelines, especially among private sector health care professionals in some regions. Appropriate diagnosis and treatment of STDs is most effectively accomplished by improving awareness and training of clinicians. Clinicians are ultimately responsible for ensuring that patients and their sex partners who are diagnosed with STDs are appropriately followed up and treated. When the diagnosis of an STD is laboratory-based, a mechanism for communicating results and following up on treatment should be established between the patient and the clinician.
Single-dose therapy for bacterial STDs is important in preventing complications and further transmission of STDs because it averts the problems of ineffective treatment associated with the failure of infected individuals to return for subsequent treatment or to take multiple doses of drugs. This attribute is especially valuable when treating disenfranchised persons. Single-dose therapy is most effective when it is directly provided and observed by the clinician, thereby ensuring patient compliance. Although single-dose therapy is more expensive than multidose therapy, it may be more cost-effective from a public health perspective for those populations in which compliance or follow-up are problematic.
Therefore, the committee makes the following recommendations:
Risk reduction counseling and education of patients during routine clinical encounters and during evaluations for potential STDs are important components