The last few decades have provided new perspectives on the increasingly complex interrelationships between the evolutionary epidemiology of STDs and their agents, human sexuality, and economic, social, cultural, and technological developments. Rapidly emerging HIV/AIDS, globalization, migration, and information technology are some factors that stress the importance of focusing on how old and new sexually transmitted infections (STIs) are spread, both in and between networks and populations. This review of determinants of STI transmission emphasizes their impact on disease prevalence and transmission, as well as their potential for affecting the agents themselves--directly or indirectly. Interventions aiming to control the spread of STIs and HIV on the different levels of society need to be adapted to the specific environment and need to integrate social structures, such as economic and gender inequality and mobility, as well as the great variability and complexity of sexual behavior.
© 2011 New York Academy of Sciences.