Infrastructure limitations prevent an accurate appreciation of the STI burden in Guyana; there is only one dedicated treatment centre in the country, the Genitourinary Medical (GUM) Clinic in Georgetown. CSIH’ s assessment indicates that Guyana’s STI diagnostic, treatment and monitoring capacity is weak, and that the GUM clinic is struggling with the management of its STI cases. Because of a significant lack of STI diagnostic capability, most conditions are treated without sufficient diagnostic assertion of appropriate treatment.

• According to a 1997 study by the Caribbean Epidemiology Centre, 42.7% of those attending the GUM clinic are HIV positive
• According to a 1998 University of Miami study, one third of sex workers in Georgetown are infected with Syphilis
• According to PAHO, in 1995 the following cases were diagnosed at the GUM Clinic:

-625 cases of gonorrhea
-325 cases of syphilis
-856 cases of nongonococcal infections

For persons living outside the capital, distance represents an obstacle to getting tested and treated. Those who can afford it can turn to private laboratories, but a very large number will remain untested.

There is a high degree of concordance between HIV and STI infection, particularly for the more nefarious STIs, like syphilis and gonnorhea. A very large proportion of patients presenting to the GUM clinic for treatment of syphilis prove to be HIV positive.

Epidemiologic studies demonstrate that a history of an STI is associated with an increased risk for HIV infection, presumably because sexual behaviors increase the risk for acquiring both. Furthermore, genital ulcerations and inflammation caused by STIs are implicated as cofactors for acquiring HIV infection. Recent data suggest that in the presence of other STIs, individuals are three to five times more likely to acquire HIV if exposed to the virus through sexual contact.