HIV/AIDS and STIs
HIV, Human immunodeficiency virus, is a virus that attacks the human immune system and is spread through contact with bodily fluids, including blood and semen. It is most commonly spread through sex or sharing equipment used to inject intravenous drugs. If left untreated, HIV infection can result in AIDS, or acquired immunodeficiency syndrome. Although not exclusively spread through sex, HIV is considered a sexually-transmitted infection (STI). Other pathogens linked to the greatest incidence of STIs worldwide include syphilis, gonorrhea, chlamydia, trichomoniasis, hepatitis B, herpes simplex virus (HSV), and human papillomavirus (HPV).
HIV/AIDS and STIs have a significant impact on both sexual and reproductive health, including infertility, poor birth outcomes, cancers, and stigmatization. A major global health issue, 39 million people worldwide are living with HIV, and each day 1 million people are infected with an STI. Approximately 374 million people are diagnosed with a curable STI each year, including chlamydia, gonorrhea, syphilis, and trichomoniasis.
In the United States, HIV/AIDs first emerged among marginalized communities, such as men who have sex with men (MSM), users of intravenous drugs, and sex workers. Government systems were slow to respond and misinformation was spread regarding the transmission of HIV. As a result, marginalized communities faced significant discrimination and stigma from the public, and thousands of lives were lost. At present, gay and bisexual men, particularly Black, Latino, and Native American men, are still at greatest risk of contracting HIV and other STIs. Black women, transgender women, and those who inject drugs are also disproportionately impacted by HIV and STIs.
Unprotected sex, multiple sexual partners, and the use of injected drugs are factors that contribute to the transmission of HIV/AIDs and STIs. Additionally, existing or prior STI infection increases the risk of contracting HIV. Although prevention, care, and treatment for HIV has advanced, stigma and discrimination remain significant barriers to accessing care. Lack of education, unemployment, incarceration, and poverty contribute to a lack of STI testing, treatment, and prevention among marginalized communities.
Reducing the burden of HIV and STIs, as well as the stigma and discrimination associated with these diseases, benefits human health and quality of life. Making HIV/STI testing simple, accessible, and routine, increasing access to same-day treatment, and providing behavioral interventions to maintain engagement in care can lessen the burden of HIV and other STIs at scale. At the local level, communities can invest in prevention strategies, such as safe needle exchanges, condom distribution programs, mobile testing sites, and linkages to local social services. Communities can also prioritize education and awareness on the transmission of HIV and STIs to reduce stigma and empower individuals to seek care.