Aggressive diagnosis and treatment of STIs is important for overall health promotion and the prevention of HIV transmission and constitutes the fourth pillar of PIH’s comprehensive approach to integrated programming. Untreated STIs—particularly untreated genital ulcer disease—increase the risk of HIV transmission tenfold.¹⁴⁰ The presence of any STI increases the shedding of HIV in the genital tract; the treatment of STIs decreases viral shedding.^141,142