The origin of acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) has puzzled scientists ever since the illness first came to light in the early 1980s. For over 25 years it has been the subject of fierce debate and the cause of countless arguments. It is now generally accepted that HIV is a descendant of a simian immunodeficiency virus and there are many theories about how this 'zoonosis' originated and how SIV became HIV in humans. Advances in treatment have steadily reduced the morbidity and mortality associated with HIV infection. However, in the low-income, high-prevalence countries, antiretroviral medication has taken a long time to reach the people who actually need it. Access to medication must greatly improve if millions of deaths are to be avoided. HIV is a preventable disease. Unless great progress is made in prevention, the number of people living with HIV will outstrip the resources available for treatment. The search for effective vaccines and microbicides must therefore be one of the very highest priorities. HIV is a global threat. Action needs to be taken to prevent it killing many more millions than those who have already died. This action needs not only to continue, but to be speeded up considerably.

Trichomonas vaginalis is a parasitic protozoan that is the cause of trichomoniasis, a sexually transmitted disease (STD) of worldwide importance. Recent data have shown that the annual incidence of trichomoniasis is more than 170 million cases worldwide. In fact, the World Health Organization (WHO) has estimated that this infection accounts for almost half of all curable sexually transmitted infections. The actual burden of the disease remains unknown in India. As per the published literature, the prevalence of T. vaginalis ranges from 0.4-27.4% in women and 0.0-5.6% in men. Although T. vaginalis is the most common cause of nonviral STD, the exact mechanism of its pathogenesis has not been clearly elucidated. Standard teaching is that trichomoniasis is an important cause of vaginitis in women. The prevalence and spectrum of disease in males are less well characterized; the infection appears to usually be asymptomatic, but it has been suggested as an increasingly important cause of nongonococcal urethritis. The laboratory plays a key role in the diagnosis of this infection. The time-honored approach has been microscopic evaluation by wet mount method. The broth culture method is the 'gold standard' for diagnosis of trichomoniasis and detects twice as many infections as the wet mount method. The drug of choice is metronidazole or tinidazole. For long it has been considered a 'minor' STD. Recent literature documents that women infected during pregnancy are predisposed to premature rupture of membranes, premature labor, and low-birth-weight infants. Further, it may amplify HIV transmission. Therefore, the identification of this common treatable sexually transmitted infections offers a precious and much needed additional strategy for AIDS prevention.

With developing countries on the wave of a HIV epidemic, issues like quality of life (QOL) have come to fore. We aimed to assess the quality of life in human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) patients at antiretroviral therapy (ART) clinic in a tertiary healthcare centre in South India. The study was conducted on 60 HIV/AIDS patients attending ART clinic at a tertiary health hospital, Chennai, South India. QOL was evaluated using the WHO QOL-BREF (Field trial version) instrument using 26 items grouped under 4 domains, namely physical health, psychological well-being, social relationships, and environment on 60 HIV/AIDS patients. Standard error of the difference between means was employed to find out significant difference between domain scores and clinical categories. QOL scores were highest for environmental domain which is 46.19 (0-100 scale). QOL scores were significantly lower among persons with lower CD4 counts ( P < 0.001). Women had lower QOL scores than men despite having less advanced disease. Patients with better educational background had significantly higher psychological domain scores. Also, a supportive family kept environmental domain scores better ( P < 0.001). A need for good healthcare support system was perceived. Better education helps the patient to cope with the disease well. Family support is essential for healthier environment.

The recent years have witnessed a renewed interest in human sexual behavior, partly because of the growing AIDS pandemic. We undertook a study of the pattern of sexual behavior among outpatients attending our dermatology clinic. Sexually active patients attending the dermatology clinic for non-STD complaints from March 2007 to June 2007 were randomly selected and interviewed about their sexual behavior using a questionnaire. The study included 500 respondents (240 women, 260 men). The mean ages of the women and men were 37.9 years and 38.9 years, respectively. Forty-two of the unmarried men (54.5%) were sexually active, while 55 of the married men (30%) admitted to having had premarital sex. A total of 81 men (38.8%) admitted to premarital sex, compared to only 2.9% of women. With regard to extramarital contact, 62 of the married men (33.8%) were affirmative in their response, while the corresponding figure for married women was 12 (5.5%). Nine men had a history of bisexual contact and, of these, one man admitted to having had exclusively homosexual contact. Fifteen men had indulged in anal sex; 48.3% men with pre/extramarital contact had more than one partner, and 43 (30.1%) had visited commercial sex workers (CSWs). Most of the respondents (141; 87%) with pre/extramarital contact had had unsafe sex. Among the women with pre/extramarital sexual contact, most (17; 89.5%) had only one partner; all were heterosexual and the majority had had sexual contact with relatives (73.7%). To summarize, men had overwhelmingly more pre/extramarital sexual contact as compared to women.

The pattern of sexually transmitted diseases (STDs) at Rohtak Medical College, based on retrospective data for the period from January 2001 to December 2006, was compared with the findings of an earlier study done at the same place and with other studies available in the literature. This study included a total of 1542 patients with STDs. The male: female ratio was 5.17:1. Most of the patients were in the third decade of their lives. Herpes genitalis was the most common STD (31.26%), followed by condyloma acuminata (27.30%), syphilis (16.67%), gonorrhea (12.06%), and other diseases.

Herpes simplex virus (HSV) is one of the most common opportunistic infection in the human immunodeficiency virus- (HIV) infected adults. HIV and HSV are co-transmitters of each other. Atypical and more serious clinical manifestations of HSV infection occur in the setting of HIV-induced immunosuppresion. A study was carried out at HIV referral clinic, Govt. Medical College, Vadodara during the period February 2003 to October 2004. Two hundred cases of HIV-positive patients with mucocutaneous manifestations were examined. On the basis of history, clinical features, and biopsy, 50 patients were suspected to have herpes. Among them, genital lesions (18%) were the commonest manifestation followed by oral lesions. Prompt diagnosis, screening of females for cervical herpes, prophylaxis, and early administration of acyclovir therapy is of immense benefit.

Although chlamydial and gonorrheal urethritis are the most prevalent sexually transmitted diseases, the frequency of the co-occurrence of both the diseases is still not well established. The aim of this study was to determine the frequency of the co-occurrence of the two diseases in the southern region of Kuwait State among men with a past history of heterosexual intercourse who sought medical care for urethral discharge. Over a period from October 2005 till October 2006, a total of 475 patients were selected for the study from among the patients attending the OPD clinics of Al-Adan Hospital for treatment of sexually transmitted diseases. The subjects were screened for both gonorrhea and chlamydia with polymerase chain reaction and Gram's stain, using specimens from the urethral discharge. Out of the total of 475 patients, 125 (26.3%) had gonorrhea, 47 (9.8%) had chlamydia, and 11 (7.31%) had both diseases. We concluded that co-occurrence of chlamydia and gonorrhea may be common among males presenting with urethral discharge.

Congenital syphilis is a rare entity and is an indicator of sexually transmitted diseases in a given population. We are reporting a case of late congenital syphilis presenting with palatal perforation at an age of 13 years.

Complete rectal prolapse (full-thickness, circumferential intussusception of the entire rectal wall through the anal canal) is not a common condition. Furthermore, anorectal giant condyloma acuminata (ConA), a sexually transmitted disease caused by human papilloma viruses, is rarely reported as a cause of rectal prolapse or as occurring in association with it. We report a patient with extensive anorectal ConA who had recurrent rectal prolapse, which became irreducible and required urgent surgery for reduction and perianal and abdominal rectopexy.

Acquisition of vulval lymphangiomata is a rare occurrence; clinically characterized by the presence of circumscribed eruptions of thin walled, translucent vesicles. Here, we report a case of 18-year-old HIV-positive female with multiple smooth to warty, flesh colored papules and nodules covering labia and mons pubis with bilateral inguinal linear puckered scars with enlarged right cervical group of lymph nodes. Our case is unique because of its association with HIV.

Cervicitis is an important cause of abnormal vaginal discharge. We describe a case of vaginal discharge due to cervicitis caused by primary varicella zoster infection in a patient with chronic immunosuppression. Though a few reports of genital infection due to chicken pox are available, to the best of our knowledge, there are no reports of abnormal vaginal discharge due to cervicitis caused by chicken pox.