Evidence is so overwhelming that syphilis, herpes and other sexually transmitted diseases speed the spread of AIDS that ignoring them amounts to "public health malpractice," a top U.S. health official says.
Researchers believe that high level of venereal diseases, along with lack of circumcision, prostitution and sexual promiscuity, may largely explain why AIDS is rampant in parts of Africa and Asia and much less common elsewhere.Evidence presented Wednesday at the 11th international conference on AIDS suggests that sexually transmitted diseases are a particularly potent force in the epidemic, because they make HIV easier to catch and to spread.
Diseases that cause genital ulcers, such as syphilis, herpes and chancroid, are especially dangerous, because they make breaks in the skin where the virus can enter. Victims of these diseases are three to five times more likely than others to get HIV if they have sex with an HIV-infected person.
The risk is somewhat less from gonorrhea and other sexually transmitted diseases that don't cause ulcers, but they also at least double the risk.
Furthermore, HIV-infected people are more likely to pass the virus on to others if they also have venereal diseases. Infected women have higher levels of HIV in their vaginal secretions, and infected men carry more in their semen.
Aggressively treating these diseases can dramatically slow the spread of AIDS. After one such treatment program in rural Tanzania, new HIV infections fell by 42 percent.
"It is tantamount to public health malpractice to fail to include effective STD management as one of the key prevention strategies in countries with significant STD burdens," said Dr. Judith Wasserheit.