Sexually transmitted infection care in Pakistan: The providers perspective

Objective: To explore the healthcare providers perspectives in the management of sexually transmitted infections. Methods: The mixed-method qualitative study done in 2008 involved 51 general practitioners and specialists who are known among peers for managing sexually transmitted infections. Interviews were conducted using semi-structured instruments and recruitment was kept open within each provider type until specific themes were saturated. Providers were interviewed from 5 cities in Pakistan. Results: Each type of provider was usually found dealing with a specific population sub-group. Nearly all providers were practising personal empiricism, rarely following any standardised guidelines. Testing for asymptomatic infections such as human immunodeficiency virus, syphilis or anal infections was rare as was counselling or partner management. Conclusion: Encounters with patients suffering from sexually transmitted infections seem to be missed opportunities to control community based transmission of such infections. Implementation research is needed to better understand how to induce healthcare providers to better manage these infections, test for asymptomatic infections and advise partner management.