STD/HIV prevention in Turkey: planning a sequence of interventions

Area of Science:

• Public Health
• Epidemiology
• Social Sciences

Background:

• Assessing effective, cost-effective, and sustainable Sexually Transmitted Disease/Human Immunodeficiency Virus (STD/HIV) prevention interventions in Turkey.
• Understanding the complex interplay of social, economic, and cultural factors influencing STD/HIV epidemiology in Turkey.
• Addressing discrepancies between public health program realities and decision-maker perceptions regarding sexual health.

Purpose of the Study:

• To identify an optimal mix and sequence of early STD/HIV prevention interventions for Turkey.
• To maximize synergy among different prevention strategies.
• To inform evidence-based public health programming for STD/HIV control.

Main Methods:

• Conducted a rapid assessment including media review (newspapers, TV coverage).
• Interviewed key informants across various sectors (e.g., public health, law, healthcare, hospitality).
• Reviewed existing data on STD/HIV morbidity, sexual behaviors, migration, and sex work.

Main Results:

• Identified significant gaps between perceptions and realities of sexual behavior, STD epidemiology, and public health infrastructure.
• Observed a societal sexual double standard, gender-specific migration, and economic pressures fueling prostitution.
• Documented high syphilis prevalence among female and male sex workers in Istanbul (e.g., early latent syphilis 8-13% in females, 11% in males).

Conclusions:

• Recommended an intervention sequence starting with awareness campaigns for decision-makers and the general public.
• Emphasized the need for targeted interventions for sex workers and training for medical personnel on STDs/HIV.
• Highlighted the importance of quality assurance in laboratory diagnostics for STD/HIV.