n'a pas diminué depuis quelques années en France. A côté des maladies sexuellement transmissibles (MST) les plus fréquentes en France (condylomes, herpès ano-génital, infection à Chlamydia ), certaines MST tenues pour négligeables jusqu'alors resurgissent aujourd'hui : la gonococcie et la syphilis touchent des homosexuels masculins ainsi que, dans une moindre mesure actuellement, des hommes et des femmes dont le profil épidémiologique reste à préciser.

dans sa stratégie de lutte contre le sida. Or, les MST aiguës ne sont pas seulement des indicateurs de comportements à risque pour le VIH, mais aussi des co-facteurs puissants de sa transmission sexuelle. Agir sur le VIH sans agir de concert sur les MST reviendrait à perdre de l'efficacité et du temps. Au vu de notre expérience dans des centres MST et des Centres de dépistage anonymes et gratuits (CDAG) et au sein d'une équipe inter-disciplinaire d'éducation à la santé, nous recommandons ce qui suit :

des mesures de prévention et des traitements proposés. Ceci passe nécessairement par une modification des représentations à l'égard des MST de la part des institutions, des soignants et du public.

the incidence of human immunodeficiency virus (HIV) has not decreased. Among the most frequent sexually transmissible diseases (STD) in France (condyloma, genito-anal herpes, chlamydia infections), certain STD, considered as negligible, have reappeared : gonorrhoea and syphilis affect male homosexuals and, to a lesser degree, men and women whose epidemiological profile remains to be determined.

in its anti-aids strategy. However, acute STD are not only indicators of habits at risk for HIV, but are also potent co-factors of its sexual transmission. Fighting against HIV without creating a dialogue on STD is a waste of time and efficiency. From our experience with the STD, anonymous and free screening and the inter-disciplinary health education centres, we recommend the following :

• improved screening for HIV and other STD : concomitantly whenever possible, less invasive, free or reimbursed STD sampling, reliable and standardized techniques (polymerisation chain reaction or PCR and derivatives), itinerant screening for STD for persons who do not consult ;
• ensured early, medical, social and psychological care of HIV and STD, emphasizing the importance of compliance to treatment and prevention ;
• ensured easy access and low cost of the male and female condoms ;
• renewal and diversification of health relays, particularly in the private sector ; staff training on STD and their epidemiological novelty ; insisting on a transversal (HIV-other STD, curative-preventive, among others) and pragmatic approach (intervention studies resulting in local action) ;
• renewal of the information and advice for the public : information on the relationship between HIV and other STD, on the frequent STD that are lesser known, such as condyloma and chlamydia infections, emphasis oncompliance to prevention measures (abstinence or use of condoms) during at least three months after a risk of HIV/STD transmission or after an STD has been identified and treated.

and treatments proposed. This can only be implemented after a change in the institutions', carers and public's attitude towards STD.