The effect of HIV-1 on other infectious diseases in Africa is an increasing public health concern. In this review, we
describe the role that three major infectious diseases—malaria, sexually transmitted diseases (STDs), and tuberculosis—
have had in the HIV-1 epidemic. The high prevalence of untreated STD infections has been a major factor facilitating the
spread of HIV-1 in Africa; with the synergistic interaction between HIV-1 transmission and genital herpes being of especial
concern for control of both diseases. Increased susceptibility to tuberculosis after infection with HIV-1 has led to a rising
incidence and threat of increased transmission of tuberculosis. Clinical malaria occurs with an increased frequency and
severity in HIV-1-infected individuals, especially during pregnancy. As with tuberculosis, STDs, and other communicable
HIV-1-associated diseases, the net effect of HIV-1 might include increased rates of malaria transmission across
communities. In addition to enhancing access to HIV-1 prevention and care, public health surveillance and control
programmes should be greatly intensified to cope with the new realities of infectious disease control in Africa.
