Abstract

Women who are in a low socioeconomic status are most vulnerable to genital ulcer disease (GUD). GUD is recognized as an important co-factor for acquisition of HIV. GUD etiology has been elucidated in the past decade, with the availability of multiplex polymerase chain reaction. Worldwide, herpes simplex virus-2 (HSV-2) is the leading cause of GUD. However, mainly in women in developed countries, the incidence of GUD causation by HSV-1 is rising, owing to adolescents who are HSV-1 naïve and to increased oral sex practices. Especially in some African countries, the still high prevalence of chancroid should decrease in the next decade, because chancroid can easily be avoided and treated. Syphilitic ulcers seemed to be almost extinct, but recently there has been a resurgence of syphilis worldwide with the availability of effective HIV treatment. Development of herpes and chancroid vaccines, condom use, and the provision of education and accessible treatment facilities should help those women who now suffer from recurrent GUD infections.