Human immunodeficiency virus (HIV) & sexually transmitted diseases (STDs)

Among various factors associated with the sexual transmission of HIV, sexually transmitted diseases (STDs) seem to contribute significantly. Hence, the efforts for prevention and control of HIV have to rely largely on STD control measures. In the developing countries, both prevalence and incidence of STDs are very high. STDs impact women's health adversely for a variety of reasons such as more susceptibility than men, asymptomatic nature of infection, etc. Enormous evidence is available indicating that both ulcerative and inflammatory STDs increase the risk of HIV infection. STDs promote HIV transmission by facilitating HIV shedding in the genital tract, causing disruption of normal epithelial barrier and by deploying and activating HIV susceptible cells at the site. The effect of STD treatment intervention was studied in three controlled clinical trials conducted in Africa. Though the STD treatment intervention was shown to reduce the STD incidence in all the three studies, the decline in HIV incidence was noticed in only one of them, which, might be attributed to the differences in the study designs. To obtain reliable epidemiological data on various STDs in different communities and regions, countrywide development of adequate laboratory infrastructure for accurate diagnosis of STDs, increased outreach of awareness programmes to communities in the rural areas are some of the key issues in the fight against HIV epidemic in India.