Population Council Research that makes a difference

For this study, Population Council researchers collected data on STIs to create a baseline reference to assess epidemiological and behavioral trends within the general population and the prevalence of STIs among the general urban male population aged 15–45 years.

The study showed that Pakistan has very low levels of HIV infection in the general population, although a concentrated epidemic has been identified in high-risk groups. Researchers determined that it is important to identify the "bridging population," those people who act as the bridge for the spread of the epidemic from high-risk groups to the general population.

The results of this study addressed existing gaps in knowledge and understanding related to STIs and HIV among the bridging population of urban men in Pakistan. The multivariate model, which controlled for partner type and marital status, suggested that the bridging population is more likely to include men younger than age 27, with less education (up to ten years of schooling), and who are living in an extended family as opposed to joint or nuclear-family situations. The data analyzed in the study indicate a need to strengthen the existing interventions introduced by the government, and to take a more holistic, three-pronged approach, including behavior change, health care delivery, and monitoring and evaluation.

Behavior change can take place only if credible information is available. Behavior-change efforts are periodically reinforced by highlighting the risks associated with having multiple sexual partners. Initiatives to introduce life-education programs that focus on STI s in schools, colleges, and the workplace should also be considered to lower vulnerability.

Greater emphasis on improving the quality of health care within both the public and private sectors is required. Counseling services are essential in conjunction with greater emphasis on STI prevention in medical curriculums; better access to counseling, diagnosis, and management of STIs; and increasing the number of urban voluntary counseling and testing services and informing the public of their availability.

Monitoring and evaluation mechanisms must be put in place in the urban centers so that reliable information is made available in a timely manner. Surveys of the bridging population also need to be replicated to gauge sexual behavior and to determine whether the systems in place are working.