About AIDS

HIV isn't the only bad-news sexually transmitted disease on the loose – and some STDs are easily spread and have major consequences for poz people. Take syphilis, for example.

We've long known that co-infection with syphilis depresses immune function. It causes big drops in T4/CD4 cells, which impairs the body's ability to control the HIV, so viral load increases. In a new study in the journal AIDS [18(15):2075-2079], participants averaged a loss of 62 CD4 cells after contracting syphilis, and more than half went from "undetectable" to "detectable" viral levels. That could significantly accelerate the HIV disease process, and for some people, might mean sliding into full AIDS. The syphilis itself can be cured with antibiotics – but participants still only regained half of their lost immune strength.

Just a couple of years ago, health officials expected to end syphilis in the U.S., and soon. The good news: It's almost gone in the general population. The bad news: Stubborn pockets of infection remain, principally among African-Americans and gay men – and many of those are also HIV-positive.

That raises two red flags. First, syphilis' clinical impact on HIVers is serious. Second, syphilis serves as an epidemiological marker: HIV is spread by the same risky sex as syphilis, which indicates that too many poz people are not making safe choices to protect either themselves or their partners.

Syphilis' continued presence is "optional" – like the continuing spread of HIV. HIV-infected folks must choose safety. It benefits both themselves and their partners.