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All STDs are not created equal: an analysis of the differential effects of sexual behaviour changes on different STDs.
International Journal of STD & AIDS 2003;14:320-328.
Pinkerton SD, Layde PM, DiFranceisco W, Chesson HW, and the NIMH Multisite
HIV Prevention Trial Group.
Abstract
The same sexual behaviours that transmit HIV are implicated in the transmission
of certain other STDs, including chlamydia, gonorrhoea, and syphilis. Consequently,
it is often assumed that preventive methods that are effective against HIV
should be equally effective against other STDs. The purpose of this study
was to examine this assumption. We applied a mathematical model of HIV/STD
transmission to empirical data from a large HIV prevention intervention that
stressed sexual behaviour change. We modelled the effects of two behavioural
strategies - reducing the number of sex partners and increasing condom use-on
the proportionate change in intervention participants' cumulative risk of
acquiring HIV or a highly-infectious STD, such as gonorrhoea. The results
of this modelling exercise indicate that decreasing the number of partners
is a more effective strategy for reducing STD risk than it is for HIV risk.
In contrast, condoms are somewhat more effective at reducing the cumulative
transmission risk for HIV than for highly infectious STDs. The protection
provided by condoms for multiple acts of intercourse critically depends on
the infectiousness of the STD. The results of this study suggest caution
in extrapolating from one STD to another, or from one behavioural risk reduction
strategy to another.