The effect of HIV, behavioural change, and STD syndromic management on STD epidemiology in sub-Saharan Africa: simulations of Uganda
- 1Erasmus University Rotterdam, Department of Public Health, Rotterdam, Netherlands
- 2Johns Hopkins University School of Public Health, Department of Population and Family Health Sciences, Baltimore, USA
- 3Centre for Population and Family Health, Columbia University School of Public Health, New York, USA
- 4Institute of Public Health, Makerere University, Kampala, Uganda
- Correspondence to: Dr E L Korenromp, Erasmus University Rotterdam, Department of Public Health, PO Box 1738, 3000 DR Rotterdam, the Netherlands; ;
- Accepted 30 November 2001
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.