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Future Implications
The incidence and prevalence of STIs in the developing world are rising rapidly. According to the World Health Organization (WHO), STIs and their complications rank in the top five disease categories for which adults in developing countries seek health care. In women of childbearing age, STIs are second only to maternal factors as causes of disease and death. By far, the greatest burden of STIs is borne by women and adolescents. Control of STIs is more urgent than ever, given the devastation of the AIDS pandemic and the fact that the risk for both acquisition and transmission of HIV is heightened by the presence of STIs. In 2000, HIV surpassed tuberculosis as the world’s leading infectious cause of death among adults. The social impact of HIV has been particularly pronounced in Sub-Saharan Africa, where an estimated 70% of the 36.1 million people in the world is living with HIV, and where 14 million children have been orphaned by AIDS. In some countries, more than 20% of the adult population is infected. The effects of losing an entire generation have created economic and social dislocation—families have lost means of support; industry has lost workers; the health care system has been overwhelmed.
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STIs are a major public health
problem not only because they are among the most common causes of illness
in the world, but also because of the potentially serious complications
of untreated STIs and because of the relationship between STIs and increased
HIV transmission.