PubMed · 8292164
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J Eluf-Neto, M Booth. 1993-11-11. Hormonal contraception.. https://pubmed.ncbi.nlm.nih.gov/8292164/
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Although the development of a hormonal contraceptive for men has proved to be more of a challenge than oral contraception for women, several experimental prototypes already satisfy many of the criteria that must be met. Steroid regimes are more effective in Asians than in men of other ethnic backgrounds. They are inexpensive, and the effect is reversible.GnRH analogues are promising, but further research is needed and is being carried out. Androgens must be used as a supplement to all hormonal strategies in order to maintain normal sexual function. The impact of androgens on lipid metabolism and prostate physiology must be clarified. Lack of funding is the greatest barrier to further research and the development of a hormonal contraceptive for men.
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The interactions between HIV-1 and other viral sexually transmitted infections (STI) are complex. The presence of ulcerative and nonulcerative STD increase susceptibility of exposed individuals to HIV-1 infection by several folds. In HIV-1 infected individuals, STD increase genital tract shedding of HIV-1 and enhance the infectivity of these individuals. STD have also recently been shown to increase plasma viremia either directly or through altering the cytokine milieu, which may both increase infectivity and result in more rapid HIV-1 disease progression. HIV-1 infection in turn has effects on susceptibility to other STD as well as increasing the serverity of some infections and possibly reducing the response to antimicrobial therapy. In addition, other potential risk factors for sexual transmission of HIV-1, such as hormonal contraception in women and lack of circumcision in men, may operate partly through effects on enhancing susceptibility to STD. The mutual enhancement of transmission of HIV-1 and other STD that has fueled HIV-1 epidemics worldwide, offers the opportunity for intervention. The effectiveness of this approach has recently been demonstrated in a trial in Mwanza, Tanzania, where provision of effective treatment for STD resulted in a 40% decline in HIV-1 incidence. The implementation of effective STD management may do much to slow the spread of HIV-1.