Due to the fact that an overwhelming majority of patients with Acquired Immune Deficiency Syndrome (AIDS) acquired the infection through sexual contact, it comes as no surprise that the same populations who are at increased risk for various sexually transmitted diseases (STDs) also experience high rates of human immunodeficiency virus (HIV) infection. There is increasing evidence that some STDs may enhance the efficiency of sexual transmissions of HIV. Genital ulcers are among the genital syndromes most convincingly implicated as cofactors for potential sexual transmission of HIV. Several cross-sectional studies among heterosexual men and women in Africa originally revealed that both a history of and the presence of genital ulcers was correlated with HIV infection. These findings are complemented by those of a study of HIV infection in homosexual men in the US. This study reports a strong association between HIV antibodies and a history of syphilis and of oral or anogenital herpes. The association between HIV antibodies and genital ulcers remained after controlling for the level of sexual activity. A prospective study conducted in Nairobi provided evidence that genital ulcers, particularly chancroid, increase the susceptibility to HIV infection among women. Another prospective study in Nairobi of men who acquired an STD from a group of prostitutes known to have a very high rate of HIV infection found that men who acquired genital ulcers had 5 times the rate of HIV infection as men who acquired urethritis. In the same cohort of prostitutes, "chlamydia trachomatis" infection also increased the risk of acquisition of HIV. Effective and inexpensive antimicrobial therapy is available for most bacterial STDs. Programs for the diagnosis and treatment of STDs should be integrated into AIDS control programs. The AIDS epidemic should not become a reason for decreasing support for STD control programs but rather an incentive to initiate or strengthen such programs.
作者：P, Piot
来源：Network (Research Triangle Park, N.C.) 1988 年 9卷 2期
