Treating sexually transmitted infections -- is this the key to preventing HIV?

Sexually transmitted infections (STIs) are thought to facilitate HIV infection through heterosexual contact. STI control therefore is a public health priority. Researchers from the London School of Hygiene and Tropical Medicine and the Tanzanian National Institute for Medical Research analyzed data from a study of STI treatment in Mwanza Tanzania. More than 8500 HIV-negative adults were divided into two groups: the intervention group and a control group. Overall results confirm that the impact of prompt and effective STI treatment services on the incidence of HIV in Mwanza was due to a reduction in the duration and prevalence of symptomatic STIs. However problems arise with applying this approach in all settings. These include: many STIs do not produce symptoms; testing and effective treatment are not available in developing countries; and as an HIV epidemic progresses and infection spreads fewer HIV infections are likely to be related to STIs. This study underlines the need for: alternative strategies for STIs in women; more effective detection and treatment of STIs; and development and evaluation of treatments for genital herpes and bacterial vaginosis.