Abstract
Sexually transmitted infections (STIs) have a well-established synergistic relationship with HIV infection. Co-infection with HIV and an STI can increase the probability of HIV transmission to an uninfected partner by increasing HIV concentrations in genital lesions, genital secretions, or both.[1, 2] STI infection can also increase the likelihood of HIV acquisition by interrupting mucosal barriers, increasing the access to and concentration of HIV receptor cells, and, in women, changing the vaginal microflora to favor HIV infection.[3–6] Among patients with acute HIV (AHI), the 4–6 week interval in the HIV disease course when the virus can be detected in the blood prior to seroconversion, co-infection with an STI may be common.[7] More than 70% of AHI patients had an STI co-infection in a Malawian sexually transmitted disease (STD) clinic in two separate studies.[8, 9] However, little is known about the frequency of STI and acute HIV infection co-infection outside of the STD clinic setting.
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