You are viewing : Vol. 5, Issue 3 Oct - Dec, 2008

Sexually Transmitted Infection puts you at higher risk for HIV infection

Stella Nanyonjo Matovu

With the attention the HIV epidemic gets in the media, it is interesting that the rates of infection with sexually transmitted diseases (STDs) like syphilis, gonorrhea, chlamydia and trichomoniasis are often overlooked. Few people realize that there is a connection between increased HIV acquisition and STD infection. It has been well documented since the early 1990s that people who are infected with an STD such as gonorrhea, syphilis, or herpes are much more likely to contract HIV. It has also been noted that the chances of an HIV-infected person with an STD transmitting HIV to another person goes up dramatically. Why, you may ask. What has one have to do with the other? Experts site a couple of reasons for this connection.When a person’s skin is intact it acts as an excellent barrier against HIV. STDs such as syphilis and herpes that are characterized by lesions or ulcerations on the genitals interrupt that barrier, creating a site for HIV to enter the blood and infect the individual.

In addition, STDs like Chlamydia that don’t cause ulcers instead stimulate the white blood cells of the immune system to concentrate in the genital area to help fight the STD. Since we know that HIV attacks these very cells, when they (white blood cells also called CD4 cells) increase in concentration, it provides fertile ground for the HIV virus to prevail.We cannot rule out that other genital infections such as yeast infections commonly seen in women increase one’s susceptibility to contracting HIV. When one has a yeast infection the resulting vaginal irritation may allow easier passage for the HIV into the blood stream. Likewise, if a woman experiences yeast that is chronic, severe, and resistant to treatment, and she and her healthcare provider have ruled out other possible causes such as diabates, systemic yeast or overuse of antibiotics, she may want to consider being tested for HIV. Secondly, for reasons not quite clear, HIV-infected people who are also infected with STDs have higher concentrations of HIV in their genital fluids.

A CDC report for instance showed that men who have gonorrhea and HIV are found to have significantly more HIV in their semen than HIV-infected men without gonorrhea, which obviously means that for any one with more HIV in their sexual fluids, the chances of infecting their partner is higher. Similarly, studies in women with ulcerative STD lesions found higher levels of HIV present in their genital fluid. After treatment of the STD, the amount of HIV in the genital fluid decreased to levels similar to women without ulcerative STDs.

Therefore STD treatment reduces an individual’s ability to transmit HIV. Studies have shown that treating STDs in HIV-infected individuals decreases both the amount of HIV in genital secretions and how frequently HIV is found in those secretions.After learning the above and more, the Ministry of Health in Uganda set up several programs at grass root level to empower and educate the public on the importance of treating STDs. Even though it cannot be substituted for safer sex practices, comprehensive STD prevention, education and treatment programs play a vital role in reducing the sexual transmission of HIV. Monitoring of new STD infections rates can also give HIV prevention specialists an idea of which population is primed for an increase in HIV infection rates.

In developing countries like Uganda, combining HIV and STD prevention efforts leads to more efficient usage of funds and resources and both conditions would be better controlled.It should however be noted that while success at the population level is best, it can only be achieved if individuals take charge of protecting their own lives. Always practice safe sex but if you fail, don’t play ostrich! Get both you and your partner tested and treated for STDs.