...Tuberculosis

Tuberculosis (TB) is the world's oldest and deadliest infectious disease, killing more people every year than any other infectious disease. Last year, TB killed roughly 3 million people around the globe and killed more women than all causes of maternal mortality combined.

TB spreads as easily as the common cold. When someone with active TB sneezes, coughs, sings or speaks, the infectious TB microbe is released into the air, and someone nearby can become infected simply by breathing. TB is spread with such ease that the World Health Organization (WHO) estimates that worldwide, one person is infected with TB every minute. However, being infected with TB does not mean being sick. Of the estimated two billion people worldwide who are infected with TB, 10% of them -- nearly 200 million people -- will become sick, and therefore infectious, with active TB during their lifetime.

• TB disproportionately threatens the health of the most vulnerable members of society -- people infected with HIV, the homeless, racial/ethnic minorities, children and the poor.

• Directly Observed Treatment, Short-course (DOTS) is an inexpensive and effective method to control TB. However, a sense of complacency about TB and a lack of political support contribute to the absence of DOTS services in countries that need it the most. These countries are also those that report the highest incidence of HIV infections.

The health of people infected with HIV is further jeopardized by the threat of TB. HIV weakens the immune system, thus serving as a catalyst in the progression of a TB infection to active TB.

• Worldwide, more people infected with HIV are killed by TB than by any other disease.

• In the United States, African Americans sit at the intersection of HIV/AIDS and TB -- there are three times as many African Americans diagnosed with both TB and AIDS as whites.

• Everyone infected with HIV should get tested for TB. HIV-positive people that are infected with TB should complete the full course of a TB prevention drug therapy in order to reduce their chances of develop-ing active TB.

• In the United States, among people infected with HIV, the annual rate of TB cases is 40 times greater than among the general population.

• In the United States, people infected with HIV and TB have a 100 times greater risk of developing active TB disease than people who are infected with TB but not infected with HIV.

...Sexually Transmitted Diseases (STDs)

Throughout the world, sexually transmitted diseases (STDs) have reached epidemic proportions, with roughly 333 million new cases of curable STDs occurring among adults every year. In the United States, 12 million new cases of STDs are estimated to occur annually, 25% of which occur in young people between 13 and 19 years of age.

Like HIV, the bacteria and viruses that cause STDs are transmitted through blood, vaginal secretions and semen. People can contract any one of the known 25 STDs by engaging in unsafe vaginal, anal, or oral sex with an infected person.

• The best method of STD prevention is abstinence. However, consistent and proper use of a latex condom during anal, vaginal, and oral sex and a mutually monogamous sexual relationship with someone who does not have an STD greatly reduces the spread of STDs, including HIV.

• While STDs especially are a public health challenge in developing countries, the United States has the highest rates of STD cases of all developed countries.

• Adolescents tend to experiment with sexual behaviors without giving much thought to the outcomes of their actions, and thus are especially at risk of becoming infected with an STD, including HIV.

• HIV, genital warts and herpes cannot be cured. Other STDs can be cured if the person infected with an STD is diagnosed early and follows the appropriate treatment instructions from a medical professional.

The interconnectedness of HIV/AIDS and STDs is increasingly becoming a topic of extreme concern for public health officials around the globe. Epidemiological data collected in the southern region of the United States reveals that the incidence of HIV infections among women of childbearing age parallels that of reported syphilis and gonorrhea cases. At the 12th World AIDS Conference in Geneva in June-July 1998, researchers presented evidence that suggests infection with an STD increases risk of HIV infection, especially in women.

• In the United States, when an individual is infected with an STD, he/she is two to five times more likely to become infected with HIV.

• Genital lesions that are caused by some STDs create an entrance for HIV infection.

While the picture of the relationship between STDs and HIV is grim, recent studies suggest that treatments for some STDs reduce HIV transmission. It is important to stress that this new evidence does not mean that people infected with HIV or an STD should not consistently practice safe sex nor does it imply that STD treatments cure HIV infections.