Abstract
In the heterosexual epidemic of HIV in northern Thailand sexually transmitted diseases (STDs) play a significant role. Having contracted an STD in the previous 6 months is a statistically significant risk for seroconversion to HIV positivity in this population. Nonulcerative STDs such as gonorrhea and nongonococcal urethritis (NGU) as well as ulcerative STDs such as syphilis and chancroid seem to increase male susceptibility to HIV infection. Significant behavioral risk factors for HIV infection include multiple sexual partners and frequent sexual encounters with commercial sex workers (CSWs). In Japan gonorrhea has been under surveillance along with chlamydia since 1988 and has decreased to one-fifth of the peak level of 1984 particularly as a result of the AIDS campaign. However gonococcal urethritis (GU) transmitted via the female pharynx increased from 6.1% in 1984 to 40.0% in 1993. Gen-Probe has been effective for gonococcal detection. Unlike GU chlamydia is on the rise in Japan and the main source of infection is now in the general female population rather than the CSW population. The PCR method has proven more effective for chlamydia detection than the EIA or DNA probe method. SPFX and CAM have been effective against chlamydia. AZM has been very promising. Human papillomavirus (HPV) particularly HPV type 16 seems to be responsible for the development of cancer of the penis uterine cervix and even the prostate. Genital herpes simplex is usually caused by HSV-2 but HIV-1 can cause acute herpes which is on the rise in Japan due to changes in peoples sexual habits and to the replacement of condoms with oral contraceptives.
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