title: The effect of HIV, behavioural change, and STD syndromic management on STD epidemiology in sub-Saharan Africa: simulations of Uganda.
abstract: An assessment was made of how the HIV epidemic may have influenced sexually transmitted disease (STD) epidemiology in Uganda, and how HIV would affect the effectiveness of syndromic STD treatment programmes during different stages of the epidemic. The dynamic transmission model STDSIM was used to simulate the spread of HIV and four bacterial and one viral STD. Model parameters were quantified using demographic, behavioural, and epidemiological data from rural Rakai and other Ugandan populations. The findings suggest that severe HIV epidemics can markedly alter STD epidemiology, especially if accompanied by a behavioural response. Likely declines in bacterial causes of genital ulcers should be considered in defining policies on syndromic STD management in severe HIV epidemics.
authors.affiliation: Erasmus University Rotterdam, Department of Public Health, The Netherlands. korenromp@mgz.fgg.eur.nl
authors.forename: E L
authors.initials: EL
authors.lastname: Korenromp
authors.forename: R
authors.initials: R
authors.lastname: Bakker
authors.forename: R
authors.initials: R
authors.lastname: Gray
authors.forename: M J
authors.initials: MJ
authors.lastname: Wawer
authors.forename: D
authors.initials: D
authors.lastname: Serwadda
authors.forename: J D F
authors.initials: JD
authors.lastname: Habbema
mesh_terms: D015897:Comorbidity; D003198:Computer Simulation; D003906:Developing Countries; D016021:Epidemiologic Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D008297:Male; D015233:Models, Statistical; D015995:Prevalence; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D014454:Uganda / Q000453:epidemiology