As with all the sexually transmitted infections, prevention requires changes in the way that people behave. Since the onset of the AIDS epidemic some 15 years ago, a growing barrage of advice and exhortation to practise 'safe sex' has filled the world's media, and it seems more than a coincidence that the incidence of tricho-moniasis, which had barely changed during the
1970s, has, since then, declined precipitately in many countries and populations.
Control of trichomoniasis requires accessible, affordable and high-quality health care, as well as health promotion; this is by no means easy or cheap to provide. Whilst most new resources in this field are, naturally, targeted at controlling the spread of HIV, there is now ample evidence that controlling other STIs is one of the most cost-effective ways of doing this (Grosskurth et al., 1995). The availability of accurate and affordable diagnostic methods for trichomoniasis, whose symptoms are not specific enough to make syndromic management very useful, would be a major advance, since treatment is reasonably cheap and highly effective. Widespread implementation could have a very significant effect in slowing the spread of HIV.
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