STD Linkage with HIV

People who have STD’s are more likely to get HIV when compared to people who do not have STD’s.

Are STD’s related to HIV?

Yes. In the United States, people who get syphilis, gonorrhea, and herpes often also have HIV or are more likely to get HIV in the future. One reason is the behaviors that put someone at risk for one infection (not using condoms, multiple partners, anonymous partners) often put them at risk for other infections. Also, because STD and HIV tend to be linked, when someone gets an STD, it suggests they got it from someone who may be at risk for other STD’s and HIV. Finally, a sore or inflammation from an STD may allow infection with HIV that would have been stopped by intact skin.

STD’s can increase the risk of spreading HIV

HIV-infected persons are more likely to transmit HIV when they have urethritis or a genital ulcer. When HIV-infected persons get another STD, such as gonorrhea or syphilis, it suggests that they were having sex without using condoms. If so, they may have spread HIV to their partners.

Some STD’s are more closely linked to HIV than others

In the US, both syphilis and HIV are highly concentrated epidemics among men who have sex with men (MSM). In 2017, MSM accounted for 79.6% of all primary and secondary syphilis cases among males in which sex of sex partner was known. In Florida, in 2010, among all persons diagnosed with infectious syphilis, 42% were also HIV infected. Men who have syphilis are also at a very high risk of being diagnosed with HIV in the future. Among HIV-uninfected men who got syphilis in Florida in 2003, 22% were newly diagnosed with HIV by 2011.

HIV is more closely linked to gonorrhea than chlamydia (which is particularly common among young women). Herpes is also commonly associated with HIV. One meta-analysis found persons infected with HSV-2 are at 3-fold increased risk for acquiring HIV infection.

Some activities can put people at increased risk for both STD’s and HIV

Having anal, vaginal, or oral sex without a condom
Having multiple sex partners
Having anonymous sex partners
Having sex while under the influence of drugs or alcohol. This can lower inhibitions and result in greater sexual risk taking.

Screening for STD’s can help assess a person’s risk for getting HIV. Treatment of STD’s is important to prevent the complications of those infections, and to prevent transmission to partners, but it should not be expected to prevent spread of HIV.

What can people do to reduce their risk of getting STD’s and HIV?

The only way to avoid STD’s is to not have vaginal, anal, or oral sex. If people are sexually active, they can do the following things to lower their chances of getting STD’s and HIV:

Choose less risky sexual behaviors
Use condoms consistently and correctly
Reduce the number of people with whom they have sex
Limit or eliminate drug and alcohol use before and during sex
Have an honest and open talk with their healthcare provider and ask whether they should be tested for STD’s and HIV
Talk with their healthcare provider and find out if pre-exposure prophylaxis, or PrEP, is a good option for them to prevent HIV infection

If someone already has HIV, and subsequently gets an STD, does that put their sex partner(s) at an increased risk for getting HIV?

Yes, it can. HIV-negative sex partners are at greater risk of getting HIV from someone who is HIV-positive and acquires another STD. The HIV-negative sex partners of persons who are HIV-positive are less likely to get HIV if:

HIV-positive persons use antiretroviral therapy (ART). ART reduces the amount of virus (viral load) in blood and body fluids. ART can keep HIV-positive persons healthy for many years, and greatly reduce the chance of transmitting HIV to sex partners if taken consistently.
Sex partners take pre-exposure prophylaxis (PrEP) after discussing this option with his/her healthcare provider and determining whether it is appropriate (Charlene, do link to internal page new transmission technology)
Choose less risky sexual behaviors
Use condoms consistently and correctly

Will Treating Someone for STD’s prevent them from getting HIV?

No. It’s not enough. Screening for STD’s can help assess a person’s risk for getting HIV. Treatment of STD’s is important to prevent the complications of those infections, and to prevent transmission to partners, but it should not be expected to prevent spread of HIV.

If someone who is HIV-positive is diagnosed with an STD, he/she should receive counseling or information about risk reduction and how to protect one’s sex partner(s) from getting re-infected with the same STD or getting HIV.