1. Prevention of sexually transmitted diseases (STD) and counseling. Candidate of medical sciences, chief doctor I. Moskvin, intern doctor Y. Konykova

2. Structure of STIs in Novgorod oblast in 2007-2009 (number of cases). Structure of STIs in Novgorod oblast in 2007-2009 (number of cases). In 2007: all registered cases of STIs – 5302 (806.2 per 100 thousand people) In Russian Federation 457,6 per 100 thousand people. In 2008: all registered cases of STIs – 5354 (820 per 100 thousand people). In Russian Federation 457.6 per 100 thousand people. In 2009: all registered cases of STIs– 4551 (704.5 [per 100 thousand people). In Russian Federation 430.7 per 100 thousand people. 2007 год

3. Translation of the words on the diagrams from the previous slide Left side diagram, 2007: Large violet segment – trichomoniasis, 2,522 Blue segment – chlamidiosis, 906 White segment - Gonorrhea, 489 Red segment - Syphilis, 581 Green segment – ureaplasmosis, 414 Small light violet segment - Mycoplasmosis, 204 Small dark segment – genital herpes, 84 Top right side diagram, 2008: - Large violet segment – trichomoniasis, 2,421 -Green segment – ureaplasmosis, 662 -Red segment - Syphilis, 566 -Blue segment – chlamidiosis, 728 -White segment - Gonorrhea, 445 -Small light violet segment - Mycoplasmosis, 395 -Small dark segment – genital herpes, 45 Bottom right side diagram, 2009 -Large violet segment trichomoniasis, 2,039 -Blue segment – chlamidiosis, 728 -Green segment – ureaplasmosis, 662 -Red segment - Syphilis, 566 -White segment - Gonorrhea, 324 Small light violet segment - Mycoplasmosis, 281 Small dark segment – genital herpes, 54

4. Prevention of STDs is a complex of activities aimed at health preservation, prevention of possible disease development and health restoration.

5. Prevention of STDs should be done at population and individual levels.

6. Main methods of prevention on the population level: Spread of information about danger of STDs and methods of their prevention using mass media. Delivering of lectures, talks and seminars in the educational institutions for the students. Setting up drop-in centers for teenagers. Involvement of non-profit organizations of HIV patients. Training of volunteers among young people. Involvement of youth leaders into prevention activities.

7. Main methods of prevention on the population level: Developing and implementation of educational programs in sex education for various groups of population. Registration of new cases, timely hospitalization, rapid finding out and treatment of all contacted people including those who were sources of infection. Diagnostics of Gonorrhea in the OBGYN doctor’s offices and clinics. Mandatory routine check ups for sexually transmitted infections of certain groups of population. Serological control of patients in general somatical hospitals. Serological (twice) check up of pregnant women aimed at prevention of inborn syphilis.

8. Main methods of STDs prevention on the individual level: Training of patients from the risk groups aimed at reduction of new cases of STDs. Finding out new people with asymptomatic and symptomatic disease development. Effective diagnostics and treatment of infected patients. Finding out, treatment and counseling of sex partners of patients with STDs. Abstinence from sex with infected sex partner and avoiding occasional sex relations.

9. Main methods of STDs prevention on the individual level: Use of barrier methods of contraception and antiseptics. Vaccination in advance. Prevention treatment. Mandatory hospitalization of patients with infectious forms of syphilis and gonorrhea. Control of patients treatment. Mandatory visit of urologist/gynecologist every 6 months.

10. Patients requiring special attention: Intravenous drug users. Deliverers of sex services. Teenagers. Pregnant women. Health care workers.

11. Infecting biological liquids (having high risk of infecting): Blood,plasma, preserved blood. Sperm. Vaginal secretion. Any biological liquid where blood can be seen.

12. Infected biological fluids (with average level of risk) Spinal fluid. Synovial fluid. Pleural fluid. Peritoneal fluid. Breast milk.

13. Non-dangerous biological fluids (if they do not contain blood) Saliva. Lachrymal fluid. Urina. Sudor. Fecal masses.

14. Protection against professional risk of infection: Reduction to minimum manipulations with used needles, failure to put on protection caps on the disposable needles after the infection. Washing hands with soap after contact with blood or human body fluids. Use of gloves. Protection of damaged skin or open wounds with water proof bandages. Use of eye and face protection (mask, goggles). Passing over of all sharp instruments through an intermediary container.

15. Counseling is a confidential mutual conversation with a patient to help him to make a decision or cope with feelings related to his state or situation. It is a form of help through interpersonal communication.

16. Aims of counseling: Patient informing. Help in the analysis of a situation. Looking for ways to solve the problem. Discussion of aims and reasons of counseling. Evaluation of STDs and HIV infection risk level. Defining of emotional reactions and consequences of informing about presence of STDs or HIV infection, provision of psychological support to the patient Training of behavior STDs and HIV infection risk- free.

17. Conditions of effective counseling: Presence of sufficient amount of time. Accessibility of counseling. Respect and kind attitude to every patient. Confidentiality. Requirements towards space. Respect of patient’s ability to make decisions. Counseling in the language understandable for the patient.

18. Counseling is an important tool for health care workers, it increases effectiveness of diagnostics, treatment and control over STDs spread. Counseling skills are necessary for more effective communication with patients.

19. Bibliography «Sexually transmitted diseases» edit. by O. Shaposhnikov. «Sexually transmitted diseases in general practice» edited by Professor Kuznetsov. http://venerologia.policlinica.ru/ve29.html http://www.androlog.inc.ru/profil.htm