The interrelationship between human immunodeficiency virus infection and other sexually transmitted diseases

The epidemiology of HIV infection in the United States is changing, with a dramatic reduction in the incidence of new HIV infection in homosexual men over the past decade because of altered sexual practices. In contrast, heterosexual transmission of HIV is increasing and is disproportionately occurring in inner city racial minorities in association with drug use, populations that are currently experiencing epidemics of previously controlled STDs. Sexually transmitted diseases, especially genital ulcerative diseases and perhaps C. trachomatis and T. vaginalis, facilitate sexual transmission of HIV. In addition, HIV infection itself appears to increase the severity of certain STDs once they are acquired. The control of STDs, particularly in those populations that are at high risk for HIV infection, should be of high priority and should be an integral component of AIDS control programs.