Sexual Health
Sexually transmitted diseases (STDs) have been studied for many years, including work on the treponematoses - syphilis and its relationship to endemic yaws, which is not sexually transmitted - and donovanosis, which is very common in Papua New Guinea. Studies within the Sexual Health Research Program on Neisseria gonorrhoeae, the causative organism of gonorrhoea, first demonstrated that penicillin-resistant strains are present in Papua New Guinea. We also showed the high prevalence of infection with Chlamydia trachomatis. These studies led to changes in the standard treatment of sexually transmitted diseases as recommended by the Health Department. Surveys of genital ulcer disease and the most prevalent causative organisms of sexually transmitted disease, including viruses, have been undertaken. Community studies in the Asaro Valley have demonstrated that over half of randomly selected, apparently healthy women from rural villages were suffering from one or more STD.
Infection with the human immunodeficiency virus (HIV) and the disease AIDS (acquired immune deficiency syndrome) are increasing exponentially in Papua New Guinea and the rapid spread is related to the high transmission rates for sexually transmitted diseases. The Institute made an early committed response to the incipient AIDS epidemic. Studies on sexual and reproductive health, on the range of sexual behaviours which might place people at risk, on sexual and reproductive knowledge and attitudes, on sexual health education, with particular emphasis on AIDS and the use of peer educators, and on the acceptability and distribution of condoms have been carried out. In this field close liaison with other agencies and departments working on STD and AIDS has been maintained. The Institute made a strong effort to promote the establishment of a National AIDS Council, to support and coordinate the urgent multisectoral national program which was needed to prevent the spread of AIDS, and it is pleasing to report that the Council was established - albeit belatedly - in 1998. The main recent thrust of the Institute's work in the sexual health program has been on targeted peer education, among groups at greatest risk of HIV transmission - youth, transport workers, police and security staff and commercial sex workers (the Transex Project). This project has been conducted in Port Moresby, Lae and Goroka and along the Highlands Highway. Monitoring of antibiotic susceptibilities in the gonococcal isolates from different sources continues. A study of HIV positivity in urban sex workers was recently conducted: 16% of those tested in Port Moresby were positive.
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