From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection.
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It is suggested that timely provision of STD services can substantially reduce HIV incidence, but raise additional questions about the optimal way to target and implement these services to achieve the greatest effect on HIV transmission.Abstract:
Objectives: To review the scientific data on the role of sexually transmitted diseases (STDs) in sexual transmission of HIV infection and discuss the implications of these findings for HIV and STD prevention policy and practice Methods: Articles were selected from a review of Medline, accessed with the OVID search engine The search covered articles from January 1987 to September 1998 and yielded 2101 arti- cles Methods used to uncover articles which might have been missed included searching for related articles by author, and combing literature reviews In addition, all abstracts under the cat- egory "sexually transmitted diseases" from the XI and XII International Conferences on AIDS (Vancouver 1996 and Geneva 1998) and other relevant scientific meetings were reviewed Efforts were made to locate journal articles which resulted from the research reported in the identified abstracts All original journal articles and abstracts which met one of the following criteria were included: (1) studies of the biological plausibility or mechanism of facilitation of HIV infectious- ness or susceptibility by STDs, (2) prospective cohort studies (longitudinal or nested case-control) which estimate the risk of HIV infection associated with specific STDs or STD syndromes, or (3) intervention studies which quantitate the eVect which STD treatment can have on HIV incidence Results: Strong evidence indicates that both ulcerative and non-ulcerative STDs promote HIV transmission by augmenting HIV infectiousness and HIV susceptibility via a variety of biological mechanisms These eVects are reflected in the risk estimates found in numerous prospective studies from four continents which range from 20 to 235, with most clustering between 2 and 5 The relative importance of ulcerative and non-ulcerative STDs appears to be complex Owing to the greater frequency of non-ulcerative STDs in many populations, these infections may be responsible for more HIV transmission than genital ulcers However, the limited reciprocal impact of HIV infection on non-ulcerative STDs and the evidence that non-ulcerative STDs may increase risk primarily for the receptive partner (rather than bidirectionally) may modulate the impact of these diseases The results of two community level randomised, controlled intervention trials conducted in Africa suggest that timely provision of STD services can substantially reduce HIV incidence, but raise additional questions about the optimal way to target and implement these services to achieve the greatest eVect on HIV transmission Conclusions: Available data leave little doubt that other STDs facilitate HIV transmission through direct, biological mechanisms and that early STD treatment should be part of a high quality, comprehensive HIV prevention strategy Policy makers, HIV prevention programme managers, and providers should focus initial implementation eVorts on three key areas: (i) improving access to and quality of STD clinical services; (ii) promoting early and eVective STD related healthcare behaviours; and (iii) establishing surveillance systems to monitor STD and HIV trends and their interrelations (Sex Transm Inf 1999;75:3-17)read more
Citations
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Journal ArticleDOI
Performance of the APTIMA Combo 2 assay for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in female urine and endocervical swab specimens.
Charlotte A. Gaydos,Thomas C. Quinn,Thomas C. Quinn,Dean E. Willis,A. Weissfeld,Edward W. Hook,David H. Martin,Dennis Ferrero,Julius Schachter +8 more
TL;DR: The APTIMA Combo 2 assay can be a useful tool in efforts to reduce the prevalence and incidence of C. trachomatis and N. gonorrhoeae infections in sexually active women and to prevent their costly and serious sequelae.
Journal ArticleDOI
Multicentre study on factors determining differences in rate of spread of HIV in sub-Saharan Africa: methods and prevalence of HIV infection.
Anne Buvé,Carael M,Richard J. Hayes,Bertran Auvert,B. Ferry,NJ Robinson,Séverin Anagonou,L. Kanhonou,M. Laourou,S. Abega,E. Akam,Leopold Zekeng,J. Chege,M Kahindo,N Rutenberg,F. Kaona,Rosemary Musonda,T. Sukwa,Linda Morison,Helen A. Weiss,Marie Laga +20 more
TL;DR: The HIV prevalence rates in the general population confirmed the preliminary assessment of the level of HIV infection in the four cities, which was based on estimates of HIV prevalence from sentinel surveillance among pregnant women.
Journal ArticleDOI
Screening for Chlamydial Infection: U.S. Preventive Services Task Force Recommendation Statement
Ned Calonge,Ned Calonge,Diana B. Petitti,Diana B. Petitti,Thomas G. DeWitt,Thomas G. DeWitt,Leon Gordis,Leon Gordis,Kimberly D. Gregory,Kimberly D. Gregory,Russell Harris,Russell Harris,Kenneth W. Kizer,Kenneth W. Kizer,Michael L. LeFevre,Michael L. LeFevre,Carol Loveland-Cherry,Carol Loveland-Cherry,Lucy N. Marion,Lucy N. Marion,Virginia A. Moyer,Virginia A. Moyer,Judith K. Ockene,Judith K. Ockene,George F. Sawaya,George F. Sawaya,Albert L. Siu,Albert L. Siu,Steven M. Teutsch,Steven M. Teutsch,Barbara P. Yawn +30 more
TL;DR: The U.S. Preventive Services Task Force concluded that the benefits of screening nonpregnant women at increased risk are substantial and that the evidence is insufficient to recommend for or against routinely screening men.
Journal ArticleDOI
Untreated gonococcal and chlamydial infection in a probability sample of adults
Charles F. Turner,Susan M. Rogers,Heather G. Miller,William C. Miller,James N. Gribble,James R. Chromy,Peter A. Leone,Phillip Cooley,Thomas C. Quinn,Jonathan M. Zenilman +9 more
TL;DR: In 1997-1998, the estimated number of undiagnosed gonococcal and chlamydial infections prevalent in the population of Baltimore adults aged 18 to 35 years approached or exceeded the number of infections that were diagnosed and treated annually.
Journal ArticleDOI
HIV-1/AIDS and the control of other infectious diseases in Africa
Elizabeth L. Corbett,Richard W. Steketee,Feiko O. ter Kuile,Ahmed S. Latif,Anatoli Kamali,Richard J. Hayes +5 more
TL;DR: The role that three major infectious diseases--malaria, sexually transmitted diseases (STDs), and tuberculosis--have had in the HIV-1 epidemic is described.
References
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Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial
Heiner Grosskurth,Jim Todd,Ezra Mwijarubi,Philippe Mayaud,A. Nicoll,G Ka-Gina,J. Newell,Denise Mabey,Richard J. Hayes,Frank Mosha,Kesheni P. Senkoro,John Changalucha,Klokke Ah,Kokungoza Mugeye +13 more
TL;DR: It is concluded that improved STD treatment reduced HIV incidence by about 40% in this rural population of Tanzania, the first randomised trial to demonstrate an impact of a preventive intervention on HIV incidence in a general population.
Journal ArticleDOI
Epidemiological synergy. Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases.
TL;DR: Preliminary data from 83 reports on the impact of HIV infection on STDs suggest that, at a community level, HIV infection may increase the prevalence of some STDs (e.g., genital ulcerative and nonulcerative STDs), and if the same STDs facilitate transmission of HIV, these infections may greatly amplify one another.
Journal ArticleDOI
Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study.
Marie Laga,A.T. Manoka,M. Kivuvu,B. Malele,M. Tuliza,N Nzila,J Goeman,F Behets,Batter,Michel Alary +9 more
TL;DR: Non-ulcerative STD were risk factors for sexual transmission of HIV-1 in women, after controlling for sexual exposure, and offered an important additional strategy for the prevention of HIV/AIDS.
Journal ArticleDOI
Proportion of disease caused or prevented by a given exposure, trait or intervention
TL;DR: It is shown that both parameters depend—in different ways—on the frequency of the marker among cases of the disease, and on the "standardized morbidity ratio" for those with the marker.
Journal ArticleDOI
Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1
Myron S. Cohen,Irving F. Hoffman,Rachel A. Royce,Peter N. Kazembe,John R. Dyer,Celine Costello Daly,Dick Zimba,Pietro Vernazza,Martin Maida,Susan A. Fiscus,Joseph J. Eron +10 more
TL;DR: HIV-1-control programmes, which include detection and treatment of STDs in patients already infected with HIV-1, may help to curb the epidemic and targeting of gonococcal urethritis may be a particularly effective strategy.