Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm
In many countries, basic STI services are in disarray as programme resources are determined by decisions relating to a single disease entity. Such a fractured paradigm is as counterproductive for HIV as it is for other STIs. Major HIV epidemics emerged from and spread rapidly under conditions of poor STI control, and further weakening of STI control may well undermine other HIV prevention efforts. Yet experience of countries as diverse as Cambodia, Kenya, Senegal, Sri Lanka and Thailand demonstrate that wider STI control is feasible and that HIV prevention can be strengthened in doing so.