Genital ulcer disease is linked to an increased risk of HIV transmission in both homo- and heterosexual practice, and therefore the 1990s has seen its emergence as a very important sexually transmitted disease process. Whereas syphilis has been known for centuries to cause significant disease in the sexual contacts and offspring of infected patients, other agents producing soft ulcers such as chancroid and herpes simplex have now increased in prevalence. The incidence of genital ulcer disease caused by syphilis plummeted in developed countries following the availability of penicillin, and the other diseases have increased in significance. Some of these diseases can be managed by antibiotic treatment, but others such as herpes simplex virus (HSV) persist for life as a latent infection with the potential for intermittent reactivation to active disease. Education targeted towards limiting the spread of these agents and the identification of treatment modalities has become an integral part of curbing the HIV epidemic worldwide.

Five different microbial agents are commonly associated with genital ulcer disease:

1. Herpes simplex viruses (HSV-1 and HSV-2)

2. Treponema pallidum: syphilis

3. Haemophilus ducreyi: chancroid

4. Invasive serovars of Chlamydia trachomatis, causing lymphogranuloma venereum (LGV)

5. Calymmatobacterium granulomatis, causing Donovanosis

The prevalence of the different types of disease varies dramatically in different populations.