(1) Infection with other STDs is an important co-factor for transmission of HIV; genital ulcer diseases in particular, such as chancroid , provide an entry point for HIV.(2) In distinction to syphilis, the ulcers of chancroid are painful.(3) In my own area we have seen a significant rise in gonorrhoea infections, chlamydia, ano-genital warts, trichomoniasis and chancroid , more prevalent among 16 to 25-year-olds.(4) The only co-infection that has received due attention is sexually transmitted infection (syphilis, gonorrhea, chancroid etc), which is known to substantially increase vulnerability to HIV infection.(5) The most notable increases were for chancroid , chlamydia trachomatis, gonorrhoea, infectious hepatitis B, syphilis and trichomoniasis, according to the National Disease Surveillance Centre figures.(6) In the developing world, the commonest diseases are gonorrhoea, syphilis, chancroid , and HIV infection, whereas in developed countries they are chlamydial infections, non-specific urethritis, genital warts, and herpes.(7) Coinfection is a particular issue if they have had sex in an area with a high prevalence of STIs, and therefore a positive herpes culture from a genital ulcer should not obviate the need to consider and test for syphilis or chancroid as well.(8) But the agency noted that condoms seem to be less effective against genital herpes, human papillomavirus, syphilis and chancroid because lesions from these diseases may appear on skin not covered by condoms, the report said.(9) A pelvic examination in women and a perineal and penile examination in men can identify the presence of discharge, trauma, or infective lesions such as herpes or chancroid .(10) Bacterial infections such as gonorrhea, syphilis, chlamydia, and chancroid are also spread through oral intercourse.
