Prevalence of STD in HIV positive patients.

Sexually transmitted infections are believed to have existed since ancient times. Their transmission is related to human nature and frailities. They can have serious effects on the body, on the mind and can result in serious reproductive morbidity and mortality. Extensive efforts have been devoted to research and intervention of HIV/AIDS, as compared with very little attention been paid to other STI's STI's acts as cofactors (or) facilitators for HIV transmission, support the argument that research on STD's other than HIV/ AIDS can also contribute to better insight into control of HIV infection. Wasserheit1 has called this relationship "Epidemiological Synergy", a phrase that emphasises STI's enhance HIV-1 tranmission Classical STIs, both ulcerative and non ulcerative could facilitate HIV-1 transmission by increasing either the infectiousness of index case, the succeptibility of the partner (or) both. AIMS : 1. To study the prevalence of various sexually transmitted diseases in HIV patients attending the well health clinic. (WHC) 2. To study the morphological patterns of various sexually transmitted diseases in HIV patients. 3. To analyse the clinical course and recurrences of sexually tranmitted diseases and its impact on the progression of HIV disease. 4. To study the response to treatment of various sexually transmitted diseases in the presence of HIV infection. 5. To study the prevalence of mixed infections in the presence of HIV infection CONCLUSION : The high prevalence of STD's among HIV positive patients suggest that the patients have not altered their sexual behaviour pattern. 95.2% of the patients had acquired their HIV infection through sexual transmission. 70.4% of the patients belong to the sexually active and economically productive age group of 20-40 years. Ninety three cases (37.2%) of ulcerative STD's were recorded in this study. The major etiological factor for the ulcerative STD among HIV positive patients is Herpes progenitalis. It accounts for 59 cases (23.6%) of the total study group. Thirty six cases of syphilis (14.4%) were noted. Ano-genital growths (Wart and Mollusum) accounted for 44 cases (17.6%) of the total study group. Discharging STDs are the major STD's noted in female patients. There were 91 cases (36.4%) either alone (or) mixed, were noted in this study. One thirty six cases (54.4%) had dermatological manifestations among which seborrheic dermatitis is the most common dermatological manifestation, in HIV according to this study. Based on the above prevalence data, ulcerative STDs are common in males while discharging STD's are common in females among HIV positive patients. STD's due to viral etiology accounted for 106 cases, far out numbering the bacterial, fungal and protozoal causes. Thus according to this study viral STDs' are more common in HIV positive patients. Atypical morphological patterns, protracted course, delayed healing time, frequent recurrences after complete treatment were noted in syphilis, herpes progenitalis, chancroid, candidiasis, anogenital warts in this study. But this involved only in a small proportion of cases except in herpes progenitalis in which 23 out of 59 cases showed atypicality. Majority of the patients responded to usual treatment that is given to patient with out HIV infection. There were no complications during treatment. Mixed infections accounted for 57 cases (22.8%) in this study. They are becoming more common in HIV infected patients when compared with the normal population