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Findings reports on ongoing operational, economic and sector work carried out by the World Bank and its
member governments in the Africa Region. It is published periodically by the Africa Technical Department
                                        on behalf of the Region.




                   Best Practice in AIDS Prevention and Mitigation




Objectives: To gather information on special population groups -- pregnant women, military
men, truck drivers, sex workers -- through testing for common STDs and making inquiries
regarding sexual practices and attitudes using a rapid assessment methodology.

Impact on the ground: The studies (i) are the first ever reliable source of STD prevalence data
in these countries, (ii) raise awareness of policy-makers as to the magnitude of common STDs
and unsafe sexual behavior among certain population groups, (iii) validate STD treatment
guidelines, (iv) increase capacity in clinical and epidemiological skills, and (v) help to
effectively treat study participants for common STDs.

Lessons Learned:

   ·   Prevalence levels are often high. Rates for a STD reach as high as 43 percent among pregnant
       women, 9 percent among military men and 13 percent among truck drivers. It is very common
       for sex workers to have several infections simultaneously.

   ·   Disbelief in infection and risk status. Most study participants do not know they are infected and
       do not believe that they are at risk of acquiring an STD. Thus, condom use is rare among both
       men and women and sex with multiple partners is common among men.
   ·   Simple design but complex logistics. These studies, although simple and rapid in design
       compared to community-based household surveys, are still a challenge to perform in the low
       resource setting of most African countries. Ensuring high quality standards for laboratory testing
       and adequate supplies of drugs, and mobilizing truck drivers and sex workers requires a high
       degree of planning and resourcefulness.

   ·   Need to expand assessment. Two additional areas need to be included: (i) an assessment of the
       quality of existing STD clinical care in public and private settings; and (ii) an assessment of the
       health seeking behavior of persons with STD symptoms.




For more information on the STD rapid assessment study, contact Wendy Roseberry, AFTHR.
World Bank Staff: more examples of Best Practice can be found on the AIDS Home Page. To
access this page, click on Netscape. Under "location" type "http://afr" to get to the Africa Region
Home Page. Then click on Best Practice and select AIDS.