Providing accessible health care for adolescents with sexually transmitted disease.

Provision of sexually transmitted disease (STD) care for sexually active adolescents has been neglected in developing countries, although this is changing. Available evidence indicates that STDs are a serious problem among adolescents (10-19 years), especially in rural areas where services are limited for any age group. Curative care is hampered by the inadequacy of the syndromic approach for identifying adolescents with asymptomatic infections, especially Chlamydia trachomatis. There is an urgent need to asses STD interventions for adolescents in controlled studies, with numbers and follow-up sufficient to monitor changes in STD markers. Many programmes report increased uptake of condoms by youth but have been unable to demonstrate its effect on STD/HIV rates. It is unlikely that any one approach to adolescent STD services will be feasible and hence the importance of understanding the benefits and limitations of each approach.