Specially trained doctors may help reduce STIs, study says

Beijing: Doctors receiving a customised training programme may help reduce the risk of many sexually transmitted infections such as gonorrhoea and HIV, according to a new study in China. In the study, people who saw a doctor who received the training had 38 per cent lower odds of being infected with gonorrhoea or chlamydia within the next nine months than patients of doctors who had not received the training by then.

"Our trial showed, for the first time, that providing systematic training about HIV and STI prevention, treatment, and behavioural counselling to physicians in China can lead to improved levels of knowledge among those physicians as well as lower levels of new STIs among their patients," said lead author Don Operario, associate professor at the Brown University School of Public Health. "This trial demonstrates the population-level implications of educating physicians on HIV and STI prevention, treatment, and counselling," said Operario.

Researchers organised the trial as China's epidemic was ramping up in 2007 and 2008. Operario and colleagues, including Dr Thomas Coates of the University of California, Los Angeles, worked with local experts to prepare and then rigorously test a custom STI training programme to see if it would directly benefit patients by reducing their rate of STI infections and risky behaviours. They recruited 249 doctors who saw STI patients at 51 county hospitals in two Eastern provinces, Anhui and Jiangsu. Doctors at a randomly-selected half of the hospitals received the training, while doctors at the other half of the hospitals waited until after the nine-month study period to get the training.

The researchers also recruited more than 1,100 patients of the doctors from their waiting rooms. The training involved a week of on-site education in HIV and STIs including disease biology, epidemiology, treatment, behavioural intervention and stigma reduction. Doctors would then go back to practice for two months, practicing new knowledge and keeping a journal, and then returned for two-day "booster" sessions at the three- and six-month marks. Doctors and patients were assessed on their knowledge at the beginning and end of the study period. Patients were also asked at the beginning and end about their behaviours such as condom use and were tested for chlamydia and gonorrhoea.

HIV was the main concern, but it was not common enough to

produce significant changes in the study's sample size. These other more common STIs were. At the nine-month mark, patients of doctors who received the training were not only significantly less likely to have an STI, but also they were less likely to report engaging in unprotected sex and had higher HIV and STI knowledge. The study was published in The Lancet Global Health.