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1.1

STI Prevention

Guidelines for Management of Sexually Transmitted Infections, 5th Edition, 2025. Chapter 1, Prevention & Service Integration.

Prevention

Reduce STI exposure risk

  • Reduce number of sex partners.
  • Avoid high-risk behaviours: anal sex; sex under the influence of alcohol/drugs; genital trauma.
  • Promote condoms: emphasise consistent and correct use during all sexual activity (penile-vaginal, oral, anal).

Encourage regular testing

  • Most STIs are asymptomatic: Chlamydia (66% of men, 85% of women), Gonorrhoea (50% of men, 65% of women), Syphilis (60–70% of new infections) — all go unnoticed.
  • STIs are several hundred times more easily transmitted than HIV.
  • Asymptomatic STI patients can transmit to others.

Ensure complete treatment

  • Stress completing the full course of prescribed medication to avoid recurrence and antibiotic resistance.
  • Complete partner treatment is needed to avert re-infection (ping-pong effect).
  • Do not resume condomless sex before all partners have completed STI treatment.

Other interventions

  • Promote HPV and hepatitis B vaccination.
  • Promote VMMC for all non-circumcised men with an STI, or treated as partners of an STI index patient.
  • Offer PrEP for HIV prevention and PEP for recent potential HIV exposure.
  • Integrate STI services into HIV and sexual and reproductive health services to improve access and reduce stigma.

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