The contribution of STIs to the sexual transmission of HIV

New studies and meta-analyses confirm the association of HIV acquisition and transmission with recent STI, although there is considerable heterogeneity between organisms and populations. Much of the recent evidence relates to HSV-2, where the population attributable risk (PAR) percent for HSV-2 is between 25% and 35% in Africa. Mathematical models show how transmission attributable to STI varies with HIV epidemic phase, and HSV-2 becomes increasingly important as the epidemic matures. HSV-2 suppressive therapy reduces HIV concentrations in plasma and the genital tract in people co-infected with HSV, in part due to direct inhibition of HIV reverse transcriptase. Recent trials of HSV-2 suppressive therapy have not shown an impact on the risk of HIV acquisition, nor in controlling transmission from dually infected people to their sero-discordant heterosexual partners.

Английский

Current Opinion in HIV and AIDS. – 2010. – Vol. 5, № 4. – P. 305–310.