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Abstract

Discussing STIs is frowned upon in a conservative country like Saudi Arabia, where ethical and social factors give rise to many obstacles. Prevention and control of STIs, especially among the youth, is of a low priority in such societies. In addition there is considerable reluctance of public health policy makers to deal with such diseases. A total of 39049 STIs were reported to the Ministry of Health in 2006. The total number of HIV positive cases in KSA in 2008 was 13,926 cases. 3,538 cases (25.4%) were KSA nationals and 10,388 cases (74.6%) were non-nationals, Heterosexual relationships were found in 88% (428), IDUs 9% (43). Mothers to their children comprised 3% (18 cases). A retrospective cohort study was conducted in King Abdulaziz University between1st of January 2001 until the 30th of December 2010, a total number of 195 HIV patients were included in the study. Majority of these patients, 136 patients (69.74%), presented to emergency room. The major presenting symptoms were fever in 94 patients (48.20%) and cough in 66 patients (33.84%). A significantly smaller number of patients complained of diarrhea; 9 patients (4.6%). Out of 195, 10 patients were pregnant. 3 died soon after admission, 6 presented with serious complications and only 1 patient was diagnosed early and received optimum treatment resulting in an HIV negative baby. Fetal outcome consisted of 3 fetal deaths, 6 HIV positive babies, 1 abortion, and 1 HIV negative baby. We concluded that limiting testing of HIV to terminal cases and those presenting with a clear picture is the real tragedy resulting in many missed cases. Especially in pregnancy where early detection and treatment could give the baby a chance at an HIV negative existence which is the ultimate goal. It can also drastically reduce the risk of intrapartum transmission from 30% to < 2%. Even if we believe that we fall within the lowest-risk population, routine voluntary screening for HIV once every three to five years is justified on both clinical and cost effectiveness ground. One time screening in the general population would also be cost effective. Another retrospective study was conducted in King Abdulaziz university hospital to explore the association between herpes positive patients and HIV, in Saudi Arabia. Total number of 343 HSV positive patients were included in the study. The majority of the presenting symptoms were fever and headache. Out of 343 patients 43 (12.53%) were HIV positive confirmed by PCR test. 5 patients only (1.46%) had positive human papilloma virus. Out of 343 herpes positive patients 19 Patients were pregnant.11 had genital ulcer disease (GUD) out of which 7 had vulval warts as well. The high association between seropositive herpes patients and HIV in our study was purely accidental finding no screen was conducted as it is not an adopted policy to screen for STI when patient has positive result for any STI, special attention should be taken to screen the partner as early detection and appropriate treatment and, consequently, improve outcome. Awareness about HIV is another important area that needs to be explored in Saudi Arabia; A cross-sectional study was designed to explore the conception and knowledge about protection against STDs and HIV. 487 participants were randomly selected amongst the youth aged 18-25. Hesitation was faced from the administrations of universities concerning the distribution of the questionnaires. Many thought it would be inappropriate to discuss such issues with unmarried individuals. Most common source from which information was obtained by the public were primarily mass media rather than health education programs in schools. . The majority of them 448 (92%) thought that education about STDs should be given in schools Before handing out the educational material,(17%) thought that HIV was curable. After distributing the educational material the number decreased to (7%).Level of awareness regarding HIV transmission was 351(96%), with a higher percentage among males in comparison to females. Only 24(5%) from the study group thought that they would ask their partner to have a medical checkup if they got one of the STDs, 4 (3%) males vs. 20 (7%) females. Almost 40% of the participants claimed they would ask for a divorce if their partner had an STD.The study reflected that there is major defect in the basic knowledge of the population. Education about sexually transmitted diseases should be addressed early on in schools to encourage premarital screenings and hence help reduce the risk of the possible expansion of infection in the Kingdom

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