A population-based study of sexually transmitted disease incidence and risk factors in human immunodeficiency virus-infected people.
OBJECTIVE
The Minnesota Department of Health conducts active surveillance for cases of human immunodeficiency virus (HIV) infection and passive surveillance for gonorrhea, Chlamydia trachomatis infection, and syphilis. The authors linked two computerized surveillance databases to assess gonorrhea incidence and risk factors for sexually transmitted disease (STD) acquisition among people with known HIV infection.


METHODS
People diagnosed with adolescent/adult HIV infection before 1993 and still alive as of December 31, 1994 were compared to people diagnosed with gonorrhea, chlamydial infection, or primary/secondary syphilis in 1993 or 1994. Records were matched on name, date of birth, and gender. The incidence of reported gonorrhea was calculated and risk factors for STD acquisition were examined.


RESULTS
Thirty (1.3%) of 2,315 HIV-infected people were diagnosed with one or more STDs after HIV diagnosis (median interval: 3 years). There were 31 episodes of gonorrhea, seven episodes of chlamydial infection, and one episode of secondary syphilis. The gonorrhea incidence among HIV-infected people was high compared to the general population in Minnesota, even after stratifying by gender, age, and county of residence. STD acquisition was independently associated with female gender (odds ratio [OR] = 3.8; 95% confidence interval [CI] = 1.7, 8.3) and residence in Hennepin County (OR = 2.9; 95% CI = 1.2, 7.1), the most populous county in Minnesota.


CONCLUSIONS
Linkage of STD and HIV surveillance data is useful as a sentinel for high-risk sexual behavior among HIV-infected people, and it can help identify individuals who require additional interventions to prevent HIV transmission. State and local health departments should consider linking these data sources to assess trends and allocate resources.
Belongia
E A
EA
Minnesota Department of Health, Minneapolis 55440, USA.
Danila
R N
RN
Angamuthu
V
V
Hickman
C D
CD
DeBoer
J M
JM
MacDonald
K L
KL
Osterholm
M T
MT
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000150:complications / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D006069:Gonorrhea / Q000150:complications / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D011159:Population Surveillance; D012307:Risk Factors; D013587:Syphilis / Q000150:complications / Q000453:epidemiology*