PIP:

There is a high burden of sexually transmitted diseases (STDs) in many parts of Africa. As for HIV, the highest rates of STDs are found in urban men and women aged 15-35 years. STDs may be responsible for up to 17% of productive life years lost to disease in sub-Saharan urban populations. Despite this heavy burden of STDs, however, their diagnosis and treatment remain neglected by public health in most of the developing world. Many factors drive the epidemiology of STDs in Africa. The disproportionate number of men relative to women in many cities prompts many men in urban areas to have sex with a core group of prostitutes who facilitate the spread of STDs. In other cities, the frequent change of sex partners, economic factors, access to health services, lack of health education, health seeking behavior, and lack of political will play roles in the spread of STDs. Genital ulcer disease is also more frequent in Africa than in developed countries. The authors discuss the interactions between HIV and other STDs, the impact of HIV infection upon other STDs, the impact of the HIV/STD interactions upon the HIV and STD epidemics, and implications for STD and HIV control programs.