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Evolution and Medicine$
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Robert Perlman

Print publication date: 2013

Print ISBN-13: 9780199661718

Published to Oxford Scholarship Online: December 2013

DOI: 10.1093/acprof:oso/9780199661718.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 23 January 2022

Sexually transmitted diseases

Sexually transmitted diseases

(p.91) 8 Sexually transmitted diseases
Evolution and Medicine

Robert L. Perlman

Oxford University Press

Sexually transmitted pathogens and sexually transmitted diseases (STDs) are widespread in nature. Humans can be infected by over a dozen sexually transmitted pathogens. Sexually transmitted pathogens, like other pathogens, evolve in ways that maximize their basic reproductive number, R0 . Because of the special features of sexual transmission, STDs have characteristic natural histories, with long latent or asymptomatic periods during which infected people can continue to be sexually active and transmit their infections. Sexually transmitted pathogens have evolved mechanisms that evade host immune defences and so enable the pathogens to cause chronic infections. Because sexual contacts are almost always between members of the same species, sexually transmitted pathogens in general have evolved to grow in a single host species or a restricted range of hosts, a property that has hindered their study in the laboratory. Sexually transmitted pathogens in humans, like HIV, presumably entered the human population by other pathways and then evolved to be sexually transmitted among humans. Sexually reproducing organisms like ourselves face the challenge of maximizing their reproductive success while minimizing the fitness costs of STDs. Most animals limit sexual activity to times of maximal fertility. The human propensity to engage in sex throughout our adult lives renders us especially susceptible to STDs. Syphilis and HIV/AIDS exemplify common features in the evolution and natural history of STDs as well as in the cultural responses to these diseases. Combination anti-retroviral therapy for HIV makes use of evolutionary principles to minimize selection for drug-resistant viruses.

Keywords:   AIDS, anti-retroviral therapy, HIV, STDs, syphilis

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