AEGiS-13IAC: Evaluation of a socially marketed pre-packaged treatment kit for men with urethral discharge in Uganda.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Evaluation of a socially marketed pre-packaged treatment kit for men with urethral discharge in Uganda.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC765)

Kambugu FS, Jacobs B, Lwanga A, Ochwo M, Cutler JR, Tifft S, Pool R, Whitworth JA
F.S.K. Kambugu, Ministry of Health, STD/AIDS Control Programme, PO Box 7272, Kampala, Uganda, Tel.: +256 41 53 4074, Fax: +256 41 25 8981, E-mail: cutler@imul.com

BACKGROUND: HIV/AIDS and sexually transmitted diseases (STDs) are epidemic in Uganda. STDs reversibly enhance the sexual transmission of HIV, hence, improved STD management is a major strategy to prevent sexual transmission of HIV. In Uganda, most men with urethral discharge syndrome (MUD) treat themselves late and seek treatment in the informal sector or treat themselves. Drugs bought from retail drug sellers or obtained from conventional health units are usually inappropriate and inadequate. MUD avoid formal health care due to concerns about cost, lack of drugs, poor service quality and lack of confidentiality.

METHODS: To increase access to effective and adequate STD treatment for MUD, we developed and pilot tested Clear Seven, a pre-packaged treatment (PPT) kit containing ciprofloxacin, doxycycline, condoms, partner referral cards and patient information in accordance with the Uganda STD management guidelines. The kit was socially marketed in clinics, pharmacies and retail drug shops. We evaluated the feasibility, acceptability and effectiveness of this approach to STD management by interviewing MUD and their sexual partners, health workers and policy makers. In addition, we conducted focus group discussions with sexually active men and women and carried out male and female simulated STD client visits at drug shops.

RESULTS: Clear Seven users (n = 422) versus controls (n = 405) had significantly higher (p > 0.001) cure rate (84% versus 47%), treatment compliance (93% versus 87%) and condom use during treatment (36% versus 18%). Partner referral was similar for both groups but fewer Clear Seven partners were symptomatic when seeking treatment. Policy makers, health workers and MUD were very positive about Clear Seven.

CONCLUSIONS: Social marketing of a PPT kit for MUD is feasible and very effective and can greatly improve the management and control of STDs and HIV infection. In addition, the use of PPT kits has the potential for improving the management of other important health problems in developing countries.

Keywords: AEGIS, Sexually Transmitted Diseases, Product Packaging, Acquired Immunodeficiency Syndrome, HIV Infections, Sexual Partners, Social Marketing, Uganda, Developing Countries, Ambulatory Care Facilities, Delivery of Health Care, Human, Male, Female, therapy, Diagnosis
000709
ThOrC765