Years ago, many people considered HIV and other sexually transmitted diseases (STDs) as totally separate issues (some people still think so today). As you will see, these issues really are interrelated with one another, and can no longer be looked at as separate issues. Let me review with you some major points as to why HIV and other STDs are so closely linked.

Point #1: If you have an STD, this strongly indicates that you may have put yourself at risk for HIV as well. Likewise, if you have HIV, this strongly indicates that you may have put yourself at risk for other STDs. HIV is transmitted in similar ways to other STDs. Therefore, if a person became infected with HIV, hepatitis B, gonorrhea, etc., through sexual contact, this means that they were not adequately practicing safer sex. This could either be due to not using a condom, or having a condom break or fall off (usually due to incorrect use). Remember, if you have one STD, there is a strong possibility that you may have other STDs at the same time. Therefore, people with HIV should be tested for other STDs, and people with other STDs should be tested for HIV.

Point #2: If you have certain STDs, you become at greater risk for acquiring HIV. This can happen two ways. First, diseases like herpes and syphilis (and others) can cause open lesions that can allow HIV to gain easier access to the bloodstream. Therefore, when symptoms of these infections are present, a person is more likely to get HIV, than if they did not have those STDs. In addition, becoming infected with diseases such as chlamydia and gonorrhea can also increase your risk of getting HIV. This is because these infections can cause CD4 cells to go to the infected area (like in the urethra, where you urinate from) in an attempt to fight off the infection. When HIV is also present, those CD4 cells are prime targets for HIV infection. Once those cells become infected, the HIV infection is established throughout the body.

Point #3: If you already have HIV, and you get another STD like gonorrhea or chlamydia, you are more infectious to others! Studies have shown that in men with gonorrhea and non-gonococcal urethritis (most commonly due to chlamydia), the HIV viral load in semen increases. This is especially true with HIV-positive men co-infected with gonorrhea. In other words, when an HIV-positive man has these infections, he is more infectious to others, as far as HIV is concerned. When the infections are treated with antibiotics, the viral load in semen decreases once again. Antibiotic treatment does not affect the viral load in the blood. This really should come as no surprise, since infections like gonorrhea and chlamydia cause CD4 cells to enter the infected area, as a part of the immune system's attack against these infections. So, if a person has gonorrhea or chlamydia in the urethra, the HIV viral load in semen increases while the infections persist.

Point #4: If you already have HIV, and you get another STD like herpes, syphilis or genital warts, those STDs can be more severe than what is normally seen. This should come as no surprise, since the immune system is a key element in surpressing the symptoms of various STDs. The immune system may not be able to cure various STDs, but it often does a good job at keeping the symptoms less severe. If a person's immune system is damaged, those STDs basically go uncontrolled, and the symptoms can be much more severe than what is normally seen.

As a new way to reduce the further transmission of HIV, we are now starting to push STD prevention even more, especially as it relates to diseases like gonorrhea. This is in addition to traditional approaches at controlling the spread of HIV (condoms, etc.). Therefore, reducing the prevalence of various STDs can indirectly control the further spread of HIV. In addition, preventing STD transmission can prevent complications in people co-infected with HIV and other STDs.

The time has come to incorporate HIV and other STDs as a single entity. In fact, because of this very issue, the Centers for Disease Control (CDC) has combined HIV, STDs and TB, into a single department. It's time for everyone to follow their lead.

Do you want more information on HIV/AIDS, STDs or safer sex? Contact the U.S. Centers for Disease Control healthline, open 24 hours a day, seven days a week, at 1-800-CDC-INFO. Or visit The Body's Safe Sex and Prevention Forum.

Until next time . . . Work hard, play hard, play safe, stay sober!