Abstract

PIP: The Association Demografica Salvadorena, the largest family planning provider in El Salvador, added sexually transmitted disease (STD) prevention, diagnosis, and treatment to its program in 1993. Family planning and STD services are integrated in all 5 Association clinics, including a specialized adolescent clinic, and training in STD management has been provided to 40 physicians from other agencies. This process began in 1990, when the Asociacion established an STD clinic, the first in the country, an annex to a family planning clinic in San Salvador. Medical consultation, treatment, follow-up, contact tracing, and outreach to high-risk sites such as brothels were provided. There have been no problems with using the same waiting room for STD and family planning clients. Of concern, however, is the need for more aggressive outreach to youth under 20 years of age--the group at highest risk of STDs, including acquired immunodeficiency virus. Under the direction of the International Planned Parenthood Federation (IPPF)/Western Hemisphere Region's integration project, family planning programs in Jamaica, Brazil, Honduras, Antigua, Guatemala, Puerto Rico, and St Lucia have also added staff training in STDs, client counseling on STD prevention, and condom promotion to their program activities. STD diagnosis and treatment are not provided, however. Concerns that STD would dilute the effectiveness of the family planning programs by meeting the reproductive and sexual health needs of clients in a more comprehensive way.