362 Temas de actualidad • Current topics Sexually transmitted diseases in Latin America and the Caribbean

Sexually transmitted diseases (STDs) have long been known for their great impact on health. In 1995, there were an estimated 333 million new cases of curable STDs among adults around the world (1). The prevalence of STDs in many developing coun-tries, including those of Latin American and the Caribbean (LAC), is extremely high. In the AIDS era there is an urgent need to adequately control and manage these diseases. A delay in diagnosing and treating STDs can lead to chronic complications and irreversible se-quelae. Women and children suffer the main conse-quences. In women, the most serious consequences are acute and chronic pelvic inflammatory diseases, infertility, ectopic pregnancy, and cervical cancer. Infection during pregnancy may cause spontaneous abortion, stillbirth, prematurity, low birthweight, congenital syphilis, and ophthalmia neonatorum (2). Controlling STDs is also important because of their relationship with HIV transmission. Several studies have shown that both ulcerative and nonul-cerative STDs facilitate HIV transmission (3–16). STD prevention can be an important tool in con-trolling the spread of HIV. For example, in a community-based, randomized trial in the Mwanza administrative region of Tanzania, improved STD treatment and control resulted in a 42 % reduction in HIV incidence (17). LAC countries need to have more data re-garding the magnitude of STDs. Syphilis preva-lence among pregnant women provides a good basis to extrapolate to the general population. Syphilis, however, is the least prevalent of the clas-sical STDs and so is an indicator of minimum (lower limit) STD prevalence. Even given that, the serious magnitude of STDs in Latin American and the Caribbean can be seen from syphilis prevalence among pregnant women, which in 1991 range