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Objectives: Operational research for sexually transmitted disease (STD) service was conducted to: 1) create the potential for
systematic care: to assess and monitor for HIV and sexually transmitted infection (STI): 2) create the linkage among OBGYN,
Medicine and Pediatric Departments of Siriraj Hospital; 3) cervical cancer screening in HIV-infected females by Pap
smear once a year; 4) create a system file for collection of STI data of the unit; 5) promote HIV counseling, disclosure and
keep records; 6) promote condom usage and reduce risk behaviors of HIV-infected females continuously.
Methods: HIV positive females attending STD Clinic, Department of OB–GYN, Siriraj Hospital were enrolled into the
study during March 1, 2005 to September 1, 2006. The procedures include: 1) provide STI testing/treatment, risk-reduction
and HIV disclosure counseling, provision of free condoms, and cervical cancer screening at least once a year; 2) develop
standardized procedures and data collection tools and strengthen data management; 3) refer women from different
departments to the STI clinic for screening; 4) provide training in risk reduction counseling and HIV disclosure counseling.
Results: Most of the primary visits were check-up. Chlamydial infection was 2.1% (year 2005). GC infection was 0.5%
(year 2005). Abnormal Pap was significantly related to low CD4 count. L-SIL was 9.3% and H-SIL was 26.8%. Among the
participants, 10.4% had CD4 count <200 cells/cu.mm.
Conclusion: Early detection and treatment of STI was 30%. Early detection of cervical cancer and treatment were
increased. Access to ARV for HIV-1 PMTCT was also increased. Cross sectional analysis will show more realistic data
since the follow up visit might be a group who came to receive condoms which could be missed as high condom use rate.
KPI of success in good clinical tracer included increased condom use and CD4 count, decreased STI, opportunistic
infection, and viral load.
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