Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women

In Vivo Identification of Langerhans and Related Dendritic Cells Infected with HIV-1 Subtype E in Vaginal Mucosa of Asymptomatic Patients

“…One possible explanation is that inflammation predisposes the vaginal mucosa to be an efficient host for infection with the virus. It has been documented that a history of sexually transmitted diseases, both ulcerating and nonulcerating, as well as abnormal vaginal flora and bacterial vaginosis, have been associated with increased risk of HIV infection (17)(18)(19)(20)(21). In our study, four out of six seropositive cases reported a history of a sexually transmitted disease, although no pathogens could be identified at the time of biopsy in cervicovaginal lavage samples.…”

The Dynamics of Substance Use and Sex Networks in HIV Transmission

“…In Africa, the early identification and utilization of core groups of the population, particularly sex workers, to monitor the epidemic led to a consideration of popula-tion mixing patterns. [33][34][35][36] In efforts to more fully understand the dynamics underlying observed population mixing patterns, researchers have begun to focus on environmental factors, such as migratory labor practices, which facilitate transmission through the geographic diffusion and mixing of populations with varying HIV prevalences. [37][38][39][40][41] For example, investigators in Thailand found that 25% of truckers in their study had had sex with commercial sex workers, as well as with other female partners, such as their wives.…”

“…Research conducted with core group populations has helped document the fact that STIs are potent biological cofactors in the sexual transmission of HIV. 34,36,43 However, HIV-preventive interventions targeted at STI control in generalized epidemics 34,44,45 have had dramatically different results, suggesting the need for further specification of the phase of the epidemic to improve understanding of transmission dynamics and the timing of specific interventions. 46 These data suggest that STI control may be only one component of multimethod and multilevel approaches to preventing HIV infection.…”

“…34,39,40,[52][53][54][55] Exceptions include a study in Zimbabwe, where researchers found 3.4% HIV incidence among male beer hall patrons, and the only significant risk factor associated with both HIV prevalence and incidence was having had sex while intoxicated. 52 Another study in Manipur, India, found that sex workers had high HIV prevalence in general, but the prevalence was nine times higher among sex workers who also injected drugs.…”

The threat of untreatable gonorrhoea: implications and consequences for reproductive and sexual morbidity

“…Furthermore, infection with N. gonorrhoeae facilitates the transmission of HIV, and studies have shown that effective treatment of gonococcal urethritis in men reduces HIV shedding in the genital tract. 3,4 Financially, the high burden of infection with N. gonorrhoeae will have serious cost implications at the individual level, both in terms of quality of life and out-of-pocket expenditure, and bring about a major need for public health expenditure. Ebrahim et al estimated that about 1,326 disability-adjusted life years (DALYs) are attributed to 321,300 gonococcal infections.…”