Sexually transmitted infection services as a component of HIV care: findings of a demonstration project among HIV-infected women in Thailand.
OBJECTIVE
As Thailand scales up its antiretroviral treatment program, the role of sexually transmitted infection (STI) services to prevent HIV transmission has not been addressed. We provided STI services for HIV-infected women as a component of HIV care and assessed STI prevalence and risk behaviors.


METHODS
HIV-infected women attending an infectious disease clinic and an STI clinic in Bangkok were screened for the presence of genital ulcers by visual inspection, for gonorrhea and chlamydial infection by polymerase chain reaction, for trichomoniasis by wet mount, and for syphilis by serology. Women were asked about sexual risk behavior and use of antiretroviral treatment. Risk-reduction counseling, condoms, and STI treatment were provided.


RESULTS
Two-hundred ten HIV-infected women at an infectious disease clinic (n = 150) and an STI clinic (n = 60) received STI services from July 2003 through February 2004. The prevalence for any STI was 8.0% at the infectious disease clinic and 30.0% at the STI clinic (P < 0.01). Of the 116 (55.2%) sexually active women, 42 (36.2%) reported sex without a condom during the last 3 months. Women receiving antiretroviral treatment reported condom use during last sex more often compared with those not receiving antiretroviral treatment (82.2% vs. 58.8%; P = 0.03).


CONCLUSIONS
STIs and sexual risk behavior were common among these HIV-infected women, and STI services for HIV-infected persons have been expanded to more clinics in Thailand. Further analysis of HIV transmission risk is necessary for developing a national strategy for prevention of HIV transmission among HIV-infected persons.
Sirivongrangson
Pachara
P
Sexually Transmitted Infection Division, Bureau of AIDS, Tuberculosis, and STIs, Thai Ministry of Public Health, Bangkok, Thailand.
Bollen
Liesbeth J M
LJ
Chaovavanich
Achara
A
Suksripanich
Orapin
O
Jirarojwat
Naiyana
N
Virapat
Pongsri
P
Charoenwatanachokchai
Angkana
A
Lokpichat
Somchai
S
Pobkeeree
Vallerut
V
Chantharojwong
Nartlada
N
Supawitkul
Somsak
S
Tappero
Jordan W
JW
Levine
William C
WC
D000328:Adult; D002690:Chlamydia Infections / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D006069:Gonorrhea / Q000139:chemically induced / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013785:Thailand / Q000453:epidemiology