New sexually transmitted diseases in HIV-infected patients: markers for ongoing HIV transmission behavior.
OBJECTIVE
The objective of this study was to describe the rate of new sexually transmitted diseases (STDs) among HIV-infected patients and to define the behavioral and clinical characteristics of HIV-infected patients who return with a new STD in follow-up.


METHODS
The study design was a record-based clinical cohort study focusing on patients testing HIV-seropositive in the STD clinics of Baltimore, Maryland from 1993 to 1998.


METHODS
The authors identified those HIV-infected patients later diagnosed with an STD in follow-up and compared their demographic, behavioral, and clinical characteristics with those who were not diagnosed with an STD in follow-up.


RESULTS
Of 796 men and 354 women with HIV infection, 13.9% of men and 11.9% of women were diagnosed with an STD after their initial HIV diagnosis. HIV-infected men returned with a new STD at a rate of 7 cases per 100 person-years; HIV-infected women returned at a rate of 5.6 cases per 100 person-years. In men, multiple sex partners and sex worker contact were associated with a subsequent STD diagnosis (OR = 1.67, p =.037; OR = 1.82, p =.015, respectively). In women, age younger than 30 years was associated with the diagnosis of an STD after the diagnosis of HIV infection (OR = 2.94, p =.0009).


CONCLUSIONS
Patients diagnosed with HIV in an STD clinic setting commonly return with new STDs in follow-up, suggesting continued exposure of HIV to others. More intensive screening and counseling interventions focused on STD prevention in those with HIV infection is a necessary HIV prevention strategy.
Erbelding
Emily J
EJ
Baltimore City Health Department, 1830 East Monument Street, Rm 445, Baltimore, MD 21287, U.S.A. eerbeldi@jhmi.edu
Chung
Shang-En
SE
Kamb
Mary L
ML
Irwin
Kathleen L
KL
Rompalo
Anne M
AM
D000328:Adult; D000554:Ambulatory Care Facilities; D015142:Baltimore / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D015231:Sexually Transmitted Diseases, Bacterial / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D014247:Trichomonas Vaginitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology