Letters to the Editor

Abstract

Unrecognized genital ulcer disease may be a significant co-factor in HIV transmission in South Africa. The prevalence of genital ulcers was investigated in three groups of women in KwaZulu/Natal South Africa: 327 antenatal clinic patients and 189 family planning clinic clients in rural Hlabisa and 145 sex workers operating at truck stops on the main route from Durban to Johannesburg. 21 sex workers (14%) 6 pregnant women (2%) and 5 family planning clients (3%) had at least 1 genital ulcer; all were vulval. None of the sex workers or pregnant women and only 2 family planning clients were aware they had a genital ulcer. Most of these women reported abnormal urogenital symptoms and had other sexually transmitted infections that may have masked ulcer-related discomfort. 75% of these women were HIV-infected. This too may affect the symptomatology and natural history of genital ulcer disease.