"Impact of Improved Treatment of Sexually Transmitted Diseases on HIV Infection in Rural Tanzania: Randomised Controlled Trial."

Incidence of HIV-1 infection and changes in prevalence of reproductive tract infections and sexual risk behaviours: a population-based longitudinal study in rural Tanzania

“…We believe that our finding of overall prevalence of BV at 18.2% in 1993 was relatively high but representative of the general population in this region. Having a RTI or previous history of one has been shown to be associated with HIV-1 infection (Grosskurth et al, 1995;Klouman et al, 1997;Sewankambo, Gray, Wawer, Paxton, McNaim, Wabwire-Mangen, Serwadda, Li, Kiwanuka, Hillier, Rabe & Gydos, 1997;Kapiga & Aitken, 2002;Msuya et al, 2002). We found an association in this population between HIV-1 infection and a history of previous RTI in 1991, and again in 1993.…”

“…A few available aetiological RTI studies (e.g. Killewo et al, 1993;Grosskurth, Mosha, Todd, Mwijarubi, Klokke, Senkoro, Mayaudi, Changalucha, West & Hayes, 1995;Klouman et al, 1997;Msuya et al, 2002) have shown that the prevalence of various RTIs is high in the country. RTIs and HIV-1 infections have a complex reciprocal relationship described as 'epidemiological synergy' wherein RTIs increase the infectiousness of HIV-1 infected Introduction Mmbaga,Hussain,Leyna,Klouman,Masenga,Sam,Mnyika and Klepp 282 individuals and increase susceptibility in uninfected individuals (Kapiga & Aitken, 2002).…”

“…RTIs and HIV-1 infections have a complex reciprocal relationship described as 'epidemiological synergy' wherein RTIs increase the infectiousness of HIV-1 infected Introduction Mmbaga,Hussain,Leyna,Klouman,Masenga,Sam,Mnyika and Klepp 282 individuals and increase susceptibility in uninfected individuals (Kapiga & Aitken, 2002). Randomised controlled trials have shown that control of RTIs can reduce incidence of HIV-1 infection in a population (Grosskurth et al, 1995).…”

Coverage, context and targeted prevention: optimising our impact

“…The same intervention carried out in different contexts can have different impacts. For example, the reduction of HIV incidence resulting from improved syndromic treatment of cofactor STIs in Mwanza was not replicated by a community-wide mass STI treatment programme in Rakai 27 28. An important cause of these different impacts is likely to have been the different epidemiological contexts 29.…”

Association of sexually transmitted diseases and infection with the human immunodeficiency virus: Biological cofactors and markers of behavioural interventions

“…Preliminary data from a study in Tanzania utilizing a syndromic approach to the treatment of symptomatic STDs led to a 40% decrease in HIV incidence 67 . In Kinshasa, Zaire, investigators from Projet SIDA demonstrated that intensive STD diagnosis and treatment coupled with a condom distribution programme for female prostitutes successfully decreased the incidence and prevalence of both STDs and HIV 68 .…”