Sexually transmitted diseases and HIV/AIDS in Vanuatu: a cause for concern and action.

AIMS This article argues that sexually transmitted infections (STIs) and HIV/AIDS in Vanuatu are a cause for concern and that a strong response is needed to stem an epidemic. METHODS Three sources of data are used: studies and policy documents on STIs and HIV/AIDS in Vanuatu; analysis of reported STI cases from public health facilities; and key informant interviews with 14 policy stakeholders. RESULTS In Port Vila (capital of Vanuatu), more than a quarter of the women attending antenatal clinics were positive for at least one STI. Although Vanuatu Ministry of Health (MoH) case records for gonorrhoea, genital ulceration, and syphilis show national prevalence rates have remained relatively constant between 1.2% and 2%, there is probably gross under-reporting because MoH data exclude trichomoniasis and chlamydiasis cases; surveillance systems are poor; and patient access to services is limited. High STI prevalence and several socioeconomic factors create a high-risk environment for the rapid spread of HIV/AIDS. DISCUSSION The need for a strategic response in Vanuatu is pressing. Priorities for action include the scaling up of awareness programmes for young people, particularly girls, and the development of surveillance systems. Government capacity weaknesses mean the MoH should explore possible partnerships with the non-government organisation (NGO) sector and point to the need for international support to implement a new government Strategic Plan.