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
Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1
Thomas C. Quinn,Maria J. Wawer,Nelson K. Sewankambo,David Serwadda,Chuanjun Li,Fred Wabwire-Mangen,Mary Meehan,Tom Lutalo,Ronald H. Gray +8 more
TL;DR: The viral load is the chief predictor of the risk of heterosexual transmission of HIV-1, and transmission is rare among persons with levels of less than 1500 copies of HIV -1 RNA per milliliter.
Sexually transmitted diseases treatment guidelines, 2010.
TL;DR: These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 18-30, 2009.
Journal ArticleDOI
Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines
TL;DR: Ffective clinical management of STDs represent an important combined strategy necessary to improve reproductive and sexual health and to improve HIV prevention efforts, especially relevant to women, adolescents, and infants.
Journal ArticleDOI
Sexually transmitted diseases treatment guidelines, 2015.
Kimberly A. Workowski,Gail Bolan +1 more
TL;DR: These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30-May 2, 2013.
DatasetDOI
Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.
TL;DR: The most recent version of the guidelines for the prevention and treatment of opportunistic infections (OI) in HIV-infected adults and adolescents was published in 2002 and 2004, respectively as mentioned in this paper.
References
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A longitudinal study of human immunodeficiency virus transmission by heterosexual partners: de Vincenzi I for the European Study Group on Heterosexual Transmission of HIV. N Engl J Med 1994;331:341–346
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Incidence and Predictors of Human Immunodeficiency Virus Type 1 Seroconversion in Patients Attending Sexually Transmitted Disease Clinics in India
Sanjay Mehendale,Rodrigues Jj,Ron Brookmeyer,Raman R. Gangakhedkar,A. D. Divekar,Manjusha R. Gokhale,Arun Risbud,Ramesh S. Paranjape,Mary E. Shepherd,Ann E. Rompalo,Rajiv R. Sule,Sunil N. Tolat,Vijay D. Jadhav,Thomas C. Quinn,Robert C. Bollinger +14 more
TL;DR: Behavioral and biologic measures directed at the prevention and control of STDs would be expected to greatly reduce the transmission of HIV-1 infection in similar high-risk groups.
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HIV seroincidence and correlates of seroconversion in a cohort of male factory workers in Harare, Zimbabwe.
Michael T. Mbizvo,Rhoderick Machekano,William McFarland,Sunanda Ray,Mary T. Bassett,Ahmed S. Latif,David Katzenstein +6 more
TL;DR: The predictors of HIV seroconversion described in this study underscore the need for public health efforts to simultaneously address the biological, socioeconomic and behavioural factors that continue to place individuals at risk of HIV in general populations of Africa.
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Detection of HIV DNA in cervical and vaginal secretions: Prevalence and correlates among women in Nairobi, Kenya
D.B.A. Clemetson,Gregory B. Moss,Dennis M. Willerford,Michelle Hensel,W. Emonyi,King K. Holmes,Francis A. Plummer,Jackoniah O. Ndinya-Achola,Pacita L. Roberts,Sharon L. Hillier,Joan K. Kreiss +10 more
TL;DR: The identification of factors that increase the infectivity of women suggests potential strategies for reducing heterosexual transmission of HIV.
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Proportion of HIV infections attributable to other sexually transmitted diseases in a rural Ugandan population: simulation model estimates.
TL;DR: In developing countries, control of the spread of HIV infection may benefit substantially from successful STD intervention programmes, and particularly in areas where HIV infection is not already well established.