Sixth International Congress Drug Therapy in HIV Infection 17-21 November, 2002 Glasgow, UK

Background: In England, recent increases in the rates of sexually transmitted infections (STI), coupled with the emerging outbreaks of infectious syphilis, have drawn attention to the need for improving the sexual health of HIVpositive individuals.

Methods: Review of HIV, STI and behavioural surveillance data, collated by the PHLS Communicable Disease Surveillance Centre, and ad hoc research studies exploring the sexual health of HIV-positive individuals.

Results: Results HIV and STI surveillance data confirm the marked increases in the numbers and rates of diagnosed infections since 1996, with a disproportionate burden of disease falling among homosexual men and some ethnic minority groups. Data from enhanced STI surveillance programmes suggest that HIV-positive homosexual men have contributed substantially to the recent resurgence of infectious syphilis in England, and a growing proportion of this group are presenting to GUM clinics with acute STIs. Increasing high-risk sexual behaviours, including unprotected anal intercourse and high rates of partner acquisition, have undoubtedly contributed to these increasing trends. Despite this however, there is currently little evidence of concomitant increases in HIV incidence among homosexual men attending GUM clinics. STI prevention and control is also of concern among migrant African communities, among whom a disproportionate burden of bacterial STIs is also found. Whilst STI screening, in particular screening for infectious syphilis, is gaining popularity in many HIV treatment centres, review of the literature suggests that much more may be done, and that a range of effective STI prevention interventions for HIV-positive individuals have yet to be widely implemented.

Conclusions: Conclusions HIV-positive individuals form part of the transmission network for a variety of acute STIs. HIV treatment centres are a logical setting for targeting prevention activities but require a re-orientation of focus among clinic staff and clients. Innovative models of STI prevention with HIV-positive individuals, in which prevention messages are relevant and appropriate, are needed.

Presenting author: Kevin Fenton

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1 PHLS Communicable Disease Surveillance Centre, London, and Department of STDs, Royal Free and University College Medical School, London, United Kingdom.

2002-11-17
PL11-3

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