Sexually transmissible diseases and travel.

Sexually transmissible diseases (STDs) continue to be the most common notifiable infectious conditions worldwide. Their unacceptably high incidence is underlined by the recent emergence of a (presently) incurable and lethal STD, human immunodeficiency virus (HIV) infection, which merits its description as a pandemic, and with which other STDs interact in an epidemiological synergy. Certain travellers, by virtue of their behavioural interactions with 'core-groups' of efficient transmitters, may have a high relative risk of acquisition of an STD. This risk can be virtually eliminated by avoiding penetrative sexual intercourse with casual partners, especially injecting drug users and persons who have had multiple sexual partners (particularly prostitutes), or reduced by the use of condoms. The risk of parenteral exposure can be reduced by avoiding parenteral drug use and behaviour that is likely to lead to injury and by seeking facilities with adequate capabilities to screen blood donors and to sterilize instruments.