Treating sexually transmitted diseases to control HIV transmission

In four treatment studies in men with urethritis, which documented the enhanced effect of sexually transmitted diseases on HIV-1 shedding, appropriate treatment of the urethritis resulted in a dramatic reduction in the HIV shedding. The effects of sexually transmitted diseases and their treatment have been found to be similar in women, but the data are much less conclusive. Prospective studies from all regions of the world continue to correlate sexually transmitted diseases with the transmission of HIV, and in a recent trial it was shown that, in symptomatic individuals with sexually transmitted diseases, improved case management successfully lowered incident HIV infection. A randomized community-based mass therapy trial is currently underway, which will demonstrate the impact of the intensive treatment of sexually transmitted diseases on incident HIV infection.