Sexually Transmitted Diseases and the Increased Risk for HIV Transmission: Implications for Cost-Effectiveness Analyses of Sexually Transmitted Disease Prevention Interventions

Abstract

We estimated the annual number and cost of new HIV infections in the United States attributable to other sexually transmitted diseases (STDs). We used a mathematical model of HIV transmission to estimate the probability that a given STD infection would facilitate HIV transmission from an HIV-infected person to his or her partner and to calculate the number of HIV infections due to these facilitative effects. In 1996, an estimated 5,052 new HIV cases were attributable to the four STDs considered here: chlamydia (3,249 cases), syphilis (1,002 cases), gonorrhea (430 cases), and genital herpes (371 cases). These new HIV cases account for approximately $985 million U.S. in direct HIV treatment costs. The model suggested that syphilis is far more likely than the other STDs (on a per-case basis) to facilitate HIV transmission. This analysis provides a framework for incorporating STD-attributable HIV treatment costs into cost-effectiveness analyses of STD prevention programs.

TREM-2 binds to lipooligosaccharides of Neisseria gonorrhoeae and is expressed on reproductive tract epithelial cells

“…In 10 to 20 percent of women with gonococcal infection, pelvic inflammatory disease develops which includes a variety of inflammatory conditions of the upper reproductive tract including endometritis, parametritis, and salpingitis and often leads to chronic pelvic pain, infertility, and ectopic pregnancy (2). In addition, epidemiologic and clinical studies provide strong evidence that gonococcal infections facilitate the transmission of HIV-1 infection and that control of gonorrhea needs to remain high on the agenda of HIV-1 control programs (3)(4)(5)(6).…”

Vaginal discharge: evaluation of syndromic management in Chhattisgarh Institute of Medical Sciences, Bilaspur, C.G.

“…1 Untreated STD is more prone to disease spread and runs a higher risk of contracting HIV; STDs increases the risk of HIV. 2 The diagnosis and subsequent treatment often depends on clinical and laboratory diagnosis. In vaginal discharge, clinical diagnosis is often inaccurate and has limited value.…”

Human Defensins in HIV Infection: Friends or Foes?

“…Cationic peptides including defensins are required for anti-HIV activity of vaginal fluid from healthy women (Venkataraman et al, 2005). While it is well established that sexual transmitted infections (STIs) significantly increase the likelihood of HIV transmission (Chesson and Pinkerton, 2000;Cohen et al, 1997;Galvin and Cohen, 2004;Mabey, 2000;Plummer, 1998) and that levels of defensins including HNPs, HBDs and HD5 in genital fluid, are elevated in patients with STIs (Porter et al, 2005;Simhan et al, 2007;Valore et al, www.intechopen.com 2006; Wiesenfeld et al, 2002), the role of defensins in HIV transmission seems to be complex. Studies using a cohort of HIV uninfected sex workers in Kenyan demonstrated the association between an increase in HNPs and LL-37 levels in the IgA-depleted cervicovaginal secretions from women with bacterial STIs and increase in HIV acquisition, despite that cervicovaginal secretions with high levels of HNPs and LL-37 exhibited anti-HIV activity in vitro (Levinson et al, 2009).…”