Berman Stuart M, Cohen Myron S
Division of STD Prevention, CDC, Atlanta, Georgia 30333, USA.
Sex Transm Dis. 2006 Jul;33(7 Suppl):S50-7. doi: 10.1097/01.olq.0000175395.95911.85.
Rates of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) and sexually transmitted diseases (STDs) are disproportionately high in the Southern United States. A high percentage of the population is black, and STD/HIV rates are particularly high among this group. Control and treatment of STDs offers promise as an HIV prevention strategy, and nowhere more than in the South.
Identify those specific recommendations for control and treatment of STDs that available evidence indicates can reduce HIV transmission.
Review of published literature.
Community trials produced inconsistent results but still suggest that STD treatment can reduce HIV transmission in the United States. Treatment of symptomatic STDs among those with HIV-infection should reduce HIV infectivity. There is as yet only limited evidence that STD treatment can reduce HIV susceptibility, although promising studies addressing herpes simplex virus are under way.
The unacceptably large racial disparities in STD rates must be addressed, symptomatic STDs among HIV-infected individuals treated, and syphilis prevention activities continued. Detection of unrecognized HIV infections among those seeking STD services should be a priority; identification of those with STDs and acute HIV infection may provide unique HIV prevention opportunities.
美国南部人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）和性传播疾病（STD）的发病率极高。该地区很大一部分人口为黑人，而这一群体中的STD/HIV发病率尤其高。控制和治疗STD有望成为一种HIV预防策略，在南方地区更是如此。
确定现有证据表明可减少HIV传播的那些针对STD控制和治疗的具体建议。
对已发表文献的综述。
社区试验结果不一，但仍表明在美国，STD治疗可减少HIV传播。对HIV感染者的症状性STD进行治疗应能降低HIV传染性。虽然目前仅有有限证据表明STD治疗可降低HIV易感性，但针对单纯疱疹病毒的有前景的研究正在进行中。
必须解决STD发病率中存在的令人无法接受的巨大种族差异，对HIV感染者的症状性STD进行治疗，并继续开展梅毒预防活动。在寻求STD服务者中检测未被识别的HIV感染应成为优先事项；识别患有STD和急性HIV感染的人群可能会带来独特的HIV预防机会。
