Syndromic treatment of sexually transmitted diseases reduces the proportion of incident HIV infections attributable to these diseases in rural Tanzania

Abstract

These are minimal PAF estimates and they do not account for STD effects on HIV infectiousness. Nevertheless, a substantial proportion of new HIV infections in men in the comparison arm were attributable to STD. Lower PAF in the intervention arm than in the comparison arm for men provide further evidence of the role of STD cofactors in HIV transmission, supporting the hypothesis that the Mwanza intervention reduced the duration of symptomatic STD, thus reducing the HIV risk associated with such STD.

Changing patterns of knowledge, reported behaviour and sexually transmitted infections in a South African gold mining community

“…A range of other complementary interventions should be considered, including the provision of highly active antiretroviral therapy, and consideration should be given to making male circumcision available as a public health measure. There is no reason to believe that the substantial decline in prevalence that has been achieved in Uganda over the last 10 years [17] cannot be achieved in South Africa and there is evidence from other studies that interventions such as increasing condom use [18], improved STI management [19] and voluntary counselling and testing programmes can have a significant impact on HIV transmission [20]. The current study reinforces the need for broad and effective action.…”

Efforts to control sexually transmitted infections as a means to limit HIV transmission: What is the evidence?

“…The prevalence of symptomatic urethritis in men was reduced by half, and newly acquired syphilis was reduced by approximately 40%, although there was no reduction in gonococcal, chlamydial, or trichomonal prevalence in women [36]. The proportion of new HIV infections attributable to the effects of symptomatic STIs on susceptibility, the population attributable fraction (PAF), was 35.5% for the comparison arm and 4.3% for the intervention arm, strongly supporting the hypothesis that a reduction in symptomatic STIs, a cofactor in the causal pathway, led to a reduction in HIV [37].…”

Efforts to control sexually transmitted diseases as a means to limit HIV transmission: Pros and cons

“…Further analysis of the data from Mwanza, Tanzania, also points to the importance of symptomatic STDs in HIV infection [24]. In Mwanza, no statistically significant associations were found between HIV infection and STD in the intervention group-the population attributable fraction was 12.0% (95% CI, 0.0-35.9); in the comparison group, a population attributable fraction of 39.6% (95% CI, 12.4-58.3) was calculated for men with any STD.…”