Sexually Transmitted Diseases Vol. 39; No. 1: P. 1-7 (01..12)
To gain a better understanding of factors associated with HIV-
and STD-transmitting behavior among persons living with HIV,
the team estimated STD prevalence and incidence, as well as
associated risk factors, among a diverse sample of HIV-
positive patients in primary care.
The researchers analyzed data from 557 participants in the SUN
Study, a prospective observational cohort of HIV-infected
adults in primary care in four US cities. At enrollment and
six months later, participants completed an audio computer-
assisted self-interview about their sexual behavior; in
addition, they were screened for genitourinary, rectal and
pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis
infections by nucleic acid amplification testing, and for
serologic evidence of syphilis. Women provided cervicovaginal
samples, and men provided urine to screen for Trichomonas
vaginalis by polymerase chain reaction.
At enrollment, 13 percent of participants had a prevalent STD;
six months later, 7 percent had an incident STD. The most
commonly diagnosed infections were rectal chlamydia,
oropharyngeal gonorrhea, and chlamydial urethritis among the
men, and trichomoniasis among the women. Excluding
trichomoniasis, 94 percent of the incident STDs were diagnosed
among men who have sex with men (MSM). Polysubstance abuse,
other than marijuana, and having four or more sex partners in
the six months prior to testing were associated with the
diagnosis of an incident STD.
"STDs were commonly diagnosed among contemporary HIV-infected
patients receiving routine outpatient care, particularly among
sexually active [MSM] who used recreational drugs," the
authors concluded. "These findings underscore the need for
frequent STD screening, prevention counseling, and substance
abuse treatment for HIV-infected persons in care."