All the participants in the Khartoum study were HIV-negative.16 Untreated symptomatic or asymptomatic STIs are not only associated with significant morbidity, but are also associated with an increased risk of transmission of HIV.8 The presence of both ulcerative and non-ulcerative STIs has been associated with increased concentrations of HIV RNA in mucosal secretions, plasma and decreasing CD4+ cell counts.7 Identifying these hidden infections with thorough sexual history taking, genital examination and aetiological diagnosis has both individual and public health benefits. Here, CD4 is linked to sexually transmitted disease.