Use of a public sexually transmitted disease clinic by known HIV-positive adults: decreased self-reported risk behavior and increased disease incidence.
High-risk sexual behavior by HIV-positive individuals is an important factor contributing to the spread of the HIV epidemic. We conducted a retrospective chart review to compare self-reported sexually transmitted disease (STD) risk behavior and clinic diagnoses of known HIV-positive clients attending Miami-Dade County STD clinics with those of uninfected controls. One hundred ninety-one HIV-positive clients and 191 HIV-negative controls, 130 (68.1%) men and 61 (31.9%) women, were included in the analysis. HIV-positive clients were more likely than controls to report no sexual activity in the last 2 months (odds ratio [OR] = 2.6, 95% confidence interval [CI]: 1.5-4.5) or, if active, to report condom use at last sexual intercourse (OR = 3.1, CI: 1.9-5.3). However, HIV-positive clients were more likely to be diagnosed with infectious syphilis (OR = 13.0, CI: 1.6-99.4) and/or gonorrhea (OR = 2.1, CI: 1.1-4.2) than controls. This may be a result of overreporting of condom use or sexual activity in high-risk sexual networks with inefficient use of condoms. Ongoing sexual risk behavior and access to HIV primary care are important issues in this population.
Brewer
Toye Helena
TH
Department of Medicine, University of Miami School of Medicine, Miami, Florida 33136, USA. tbrewer@med.miami.edu
Metsch
Lisa R
LR
Zenilman
Jonathon M
JM
D003151:Community Health Centers / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D015994:Incidence; D008297:Male; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control*