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Harnessing Research to Combat Sexually Transmitted Diseases (STDs)

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Highlights of Some NICHD Research for STD Awareness Month

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Millions of people around the world are affected by STDs and sexually transmitted infections (STIs). Although some of these infections have few or minor symptoms, others can cause infertility and cancer, or—in the case of untreated HIV infection—death.

NICHD researchers aim to learn about these diseases, find the best ways to prevent their transmission or acquisition, slow their progression, and help treat people who are infected.

The NICHD research portfolio includes a range of projects related to STDs and STIs and their effects on the health of women, children, and youth—from preventing these conditions using effective health interventions to understanding their epidemiology and improving screening and education.

During STD Awareness Month, the Institute highlights some of its ongoing work related to STDs and STIs. Select a link below to learn more.

HIV/AIDS: From Molecules to Communities
Diverse Diseases, Diverse Approaches
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HIV/AIDS: From Molecules to Communities

According to the World Health Organization and the Joint United Nations Programme on HIV/AIDS, 34 million people around the world have HIV. To help fight this disease, the NICHD supports and conducts research to study small- and large-scale aspects of HIV.

For example, the NICHD’s Section on Intercellular Interactions studies the molecular- to tissue-level mechanisms through which HIV and other STIs gain footholds in the human body. Recently, researchers in this section determined that HIV uses an immune system protein—which is present in especially high levels in the semen of HIV-positive men—to infect cells in a woman's cervix. In another recent study, this team, led by Dr. Leonid Margolis, discovered that an anti-HIV drug also blocks the herpes virus by disabling a certain viral enzyme. By learning more about how human pathogens like HIV interact with each other and operate in the body, researchers may be able to develop new drugs to fight transmission and pathogenesis of these microbes.

Other basic and clinical research on the molecular aspects of HIV infection overlaps with Institute’s focus on contraception research. The NICHD’s Contraceptive Discovery and Development Branch (CDDB) supports research on how hormones and hormonal contraception influence the prevention and transmission of HIV. The Branch has supported one of the largest observational studies of hormonal contraception and HIV acquisition and progression. Visit http://www.ncbi.nlm.nih.gov/pmc/?term=HC-HIV%20study for a list of scientific articles related to or resulting from this study.

The NICHD also supports large-scale, community-based studies on HIV through some of the work of its Maternal and Pediatric Infectious Disease Branch (MPIDB). In particular, two studies conducted through the MPIDB-supported Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) aim to prevent, diagnose, and treat HIV among young people at community-based clinical sites around the country:

  • ATN researchers joined the Centers for Disease Control and Prevention (CDC) to initiate the Strategic Multisite Initiative for the Identification, Linkage and Engagement in Care of Youth with Undiagnosed HIV Infection (SMILE in CARING for YOUTH). In this collaboration, CDC-supported clinics, hospitals, and health departments across the country provide HIV testing and counseling to youth, while ATN’s clinical sites connect HIV-positive youth with treatment. By incorporating research into care, SMILE in CARING for YOUTH is helping to identify the best ways to bring HIV prevention and care to the young people, a population that is often hard to reach and that has unique needs.
  • Another ongoing ATN prevention effort is related to pre-exposure prophylaxis (PrEP), anti-HIV drugs that may prevent infection in high-risk, HIV-negative people. In Project PrEPare External Web Site Policy, which focuses on young men, ATN scientists are examining whether a PrEP drug approved for adults can help young people, too. Project PrEPare is studying the drug at 14 sites around the country among young men who have sex with men, a group that is at particularly high risk of infection.

The Global Partnerships for Social Science and Behavioral Research on HIV/AIDS addresses community and population-based aspects of HIV on an international scale. The Partnerships, supported through the Population Dynamics Branch (PDB), aim to understand the behavioral and social factors that influence HIV transmission in areas of the world where transmission rates are very high. This knowledge can help inform education and intervention strategies that can be applied globally.

This full-spectrum approach to understanding HIV/AIDS will help individuals, families, and communities to prevent new HIV/AIDS infections while improving care for those who are HIV positive.

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Diverse Diseases, Diverse Approaches

HIV is only one of many STDs and STIs that affect people’s health. Current estimates suggest that more than 110 million people in the United States are affected by at least one of several STIs (see infographic, below). The NICHD research portfolio includes studies of STDs and STIs in addition to HIV and incorporates a number of diverse approaches to understand these diverse diseases.

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For example, the Prevention of HIV/AIDS and other STIs program within the CDDB supports the development of dual-protection technologies—contraceptives that simultaneously protect individuals from both disease and unintended pregnancy. This includes work on microbicidal spermicides and a new female condom.

The STDs and HIV/AIDS program of the PDB addresses population-level factors and behavioral aspects of STD prevention and transmission, including abstinence and condom use. Latex condoms, when used correctly and consistently, are known to help prevent the spread of some STDs and STIs. According to findings from the National Survey of Family Growth, 93.4% of sexually active females in the United States, age 15 to 44, had male partners use a condom. (The survey is led by the CDC and partially funded through the PDB.) Understanding the factors that affect condom use is an important part of preventing the transmission of STDs and STIs as well as unintended pregnancies.

The Institute also supports studies of STIs, such as human papillomavirus (HPV) and herpes, in the context of how they interact with or influence HIV transmission. One recent study, found that the vaccine for HPV could help to protect HIV-positive women from the most serious types of HPV, even if they have already been exposed to some strains of the virus. In addition, the Microbicide Trials Network, funded by the National Institute of Allergy and Infectious Diseases and co-funded by the MPIDB, conducts trials of topical gels that can inhibit HPV, herpes, and HIV in the female genital tract.

A recent Spotlight, February is International Prenatal Infection Prevention Month, described NICHD research efforts on other STDs and STIs, both within the context of HIV and unrelated to HIV, in the Focus on Other Infections section.

STDs and STIs can have far-reaching effects on health and quality of life of millions of people around the world. Through its research, the NICHD aims to make preventing and treating these diseases a reality, particularly for women, teens, and young adults.

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Originally Posted: April 16, 2013

 

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Last Updated Date: 04/16/2013
Last Reviewed Date: 04/16/2013
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