Sexually transmitted diseases in HIV-positive patients

The complex interaction between sexually transmitted diseases (STDs) and the human immunodeficiency virus (HIV) has been demonstrated in many epidemiologic studies and clinical trials over the last number of years. On one hand, the natural history of classic sexually transmitted infections is altered by concurrent HIV infection and on the other, the transmission and course of HIV is modified. The burden is enormous. In 1995, it was estimated by the World Health Organization that 333 million new episodes of STDs had occurred.(52) The impact of HIV and its resulting immunosuppression, on the classic manifestations and management of STDs has been noted from the beginning of the AIDS epidemic. Herpes simplex virus (HSV), human papillomavirus (HPV), and syphilis are all accepted to have different manifestations, effects, and therapeutic responses in HIV positive patients.