National HIV Prevention Conference Atlanta, Georgia, USA — August 29- September 1, 1999

Natl HIV Prev Conf 1999 Aug 29-Sep 1:(abstract no. 738)
Golden M
Center for AIDS and STDs, University of Washington.

CONTEXT: Sexually transmitted diseases (STDs) are biological markers of high-risk sexual behaviors and factors thought to enhance the transmission of the human immunodeficiency virus (HIV).

OBJECTIVE: To determine the incidence and risk factors for STDs in people with HIV.

DESIGN: Linkage of STD case reports to STD diagnosis data derived from an ongoing chart review cohort study of HIV-infected people 1989-1997.

SETTING: Nine hospitals and clinics providing HIV care in Seattle-King County.

PATIENTS: Systematic sample of 2966 men and 387 women with HIV.

MAIN OUTCOME MEASURES: Incidence density (cases/100 person years) of diagnosed gonorrhea, genital chlamydial infection, primary and secondary syphilis, nongonococcal urethritis, pelvic inflammatory disease and trichomoniasis.

RESULTS: During a median follow- up of 2.1 years, 207 men were diagnosed with 275 STDs (3.57 cases/100 person years) and 77 women were diagnosed with 116 STDs (10.27/100 person years). On Cox multivariate analysis, incident STDs in men were associated with younger age (p<.001), being a man who has sex with men (MSM) (RH 3.41 95% CI 1.6-7.2) not taking antiretroviral therapy (RH 1.49 95% CI 1.1-2.0) and having CDC class A or B disease (RH 1.80 95% CI 1.2-2.7, RH 2.5 95% CI 1.6-3.7 for classes A and B vs. C, respectively). In women, STDs were associated with injection drug use (RH 1.94 95% CI 1.2-3.2), being African American (RH 2.07 95% CI 1.3-3.4) or Hispanic (RH 3.83 95% CI 1.5-9.5) and alcoholism (2.15 95% CI 1.3-3.5).

CONCLUSION: Young, HIV+MSM, men early in the course of their HIV infection and HIV+ men not receiving antiretroviral treatment are at high risk of contracting STDs. Minority women and women who use injection drugs or alcohol are likewise at high risk for STDs. These groups should be the focus of intense prevention efforts.

PRESENTER CONTACT INFORMATION:
Name: Matt Golden, MD
Address: Center for AIDS and STDs
University of Washington
1001 Broadway, Suite 215
Telephone: (206) 731-6829
Fax: (206) 731-5622
E-mail: golden@u.washington.edu

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738

Centers for Disease Control and Prevention. National HIV Prevention Conference, 1999. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, August 29- September 1, 1999.

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