Associations between HIV, sexually transmitted diseases, and antimicrobial resistance in the era of combination antiretroviral therapy and antibiotics

The advancement of combination antiretroviral therapy (cART) has dramatically transformed the management of human immunodeficiency virus (HIV), significantly reducing morbidity and mortality rates. However, the coexistence of sexually transmitted diseases (STDs) and antimicrobial resistance (AMR) presents interconnected challenges that compromise these advances in this era. This review explores the intricate associations between HIV, STDs, and AMR in the framework of extensive cART and antibiotic usage. Published literature on epidemiological data was analyzed to identify the patterns of co-infection and resistance trends, examining how the suppression of HIV influences the prevalence and treatment outcomes of concurrent STDs. Furthermore, the impacts of antibiotic overuse or misuse on the emergence of resistant strains of common bacterial STDs were investigated, particularly focusing on pathogens such as Neisseria gonorrhoeae and Mycoplasma genitalium among HIV-infected individuals. The findings highlight the critical need for integrated surveillance, antimicrobial stewardship, expanded vaccination, and culturally sensitive public health strategies. By enhancing our understanding of these interactions, this review intends to inform alterations in the existing public health policies and to upgrade previously optimized treatment protocols in the near future to improve patient outcomes in the era of cART and antibiotics.