Sexually transmitted infections may assume an increasingly important role in the evolution of HIV transmission in Europe

Findings presented at the XIV International AIDS conference in Barcelona last week (7-12 July 2002) indicate that sexual transmission of HIV is assuming increasing importance in the western European context, in terms both of increased rates of reported new cases of heterosexual transmission, and of continuing transmission between men who have sex with men (MSM) (1). In some countries, such as the United Kingdom, Belgium and Denmark, relatively high and increasing proportions of new cases of heterosexual HIV transmission occur in migrants from countries with generalised HIV epidemics, where prevalence of sexually transmitted infections (STIs) may also be high (2-4). In other countries, particularly those of southern Europe, there is evidence of significant ongoing heterosexual transmission from injecting drug users (IDUs) (predominantly male) to their sexual partners (5).