Diagnosis and Treatment of Sexually Transmitted Infections I.
Definition of the Prevention Area Sexually transmitted
infections (STIs) likely facilitate HIV transmission and
acquisition. STI treatment efforts have been used as an HIV
prevention approach with mixed outcomes. This prevention
strategy may be most effective in settings with a high burden of
STIs and when targeted to most-at-risk populations and their
sexual partners. However, randomized trials have found STI
treatment to have little to no effect on HIV incidence. II.
Epidemiological Justification for the Prevention Area The role
of STIs in the transmission dynamics of HIV epidemics is
paradoxical and complex. Population-based studies have found
that both the prevalence and incidence of HIV were substantially
higher in people with STIs. Both curable STIs and chronic
infections such as herpes simplex virus type-2 (genital herpes)
can increase vulnerability to HIV infection by disrupting skin
and mucosal barriers and/or by causing inflammation that