ABSTRACT
Worldwide, there has been a huge increase in the incidence of sexually transmitted infections (STIs) and infection with human immunodeficiency virus (HIV). In the developed world, this is at least partially related to changing sexual attitudes and lifestyles: in resource-poor countries associated factors are poverty, armed conflict, civil unrest, migration, inadequate societal infrastructure, and poor access to education. Apart from the increasing prevalence of infection with HIV, there is a resurgence of syphilis and gonorrhea (1). There are high endemic levels of syphilis in pregnant and nonpregnant women in many North American cities, related to poverty, prostitution, and crack cocaine usage (2). The prevalence of chlamydial infection in sexually active young people in Northern Europe is around 10% (3). The chances are increasing, therefore, that specialists in gynecology and reproductive health will encounter STIs and other genital infections in daily practice. Many of these will compromise not only fertility but also satisfactory pregnancy outcome. There is an increasing body of evidence linking the transfer of HIV and progression of clinical HIV disease to the active inflammation associated with genital infections (4).
