Prevention and Treatment of Sexually Transmitted Infections
Sexually transmitted infections (STI) have been shown to be important cofactors in the transmission and acquisition of HIV infection. For example, in Rakai, Uganda, research has shown an emergence of genital herpes simplex virus (HSV) in areas with mature HIV epidemics (i.e., areas with a high prevalence of HIV). Investigators found a nearly fivefold association of HSV with HIV-1 acquisition. Having uncovered this synergistic effect between STIs and HIV, researchers now hypothesize that control of one may have beneficial effects on the control of the other.
Effective STI control requires both targeted and more generalized strategies. Targeted interventions that reduce transmission in groups such as sex workers, migrant workers, and truck drivers have led to rapid STI control in several areas, particularly in Thailand, the South African mining areas, and Nairobi. Meanwhile, research has shown that improved access to quality STI services for the general population alone can have a measurable impact on HIV transmission, especially in populations with growing HIV epidemics. These examples provide evidence that control of STIs in the context of HIV transmission may represent an effective HIV prevention strategy.
Therefore, NIAID is supporting research to identify strategies that control STIs as a way to reduce the incidence of HIV.