title: Tackling STI epidemics through the HIV clinic: is sex high enough on the agenda?
abstract: Sexually transmitted infection (STI) rates among men having sex with men continue to increase. HIV services may operate independently to genitourinary medicine clinics and the sexual health of HIV-positive patients may be of low priority in the context of medical problems related to HIV. A prospective study of HIV-positive gay men was conducted in a London outpatient clinic over a three-month period. Data were available for 90 men. Forty-five percent had STI screens in the preceding six months. These revealed a high rate of infections; 26 infections diagnosed in 14 men in the study period. Fifty-seven percent of the 90 men in the study had more than one partner in the past three months and approximately one-third had unprotected sexual activity. A significant proportion of men were unaware of recent outbreaks of hepatitis C and lymphogranuloma venereum and of HIV postexposure prophylaxis. We therefore recommend that sexual history-taking, STI screens and health promotion should become a routine feature of HIV outpatient consultations in this group.
authors.affiliation: Department of Genitourinary Medicine, Mortimer Market Centre, Camden Primary Care Trust, London.
authors.forename: R A
authors.initials: RA
authors.lastname: Ferrand
authors.forename: S
authors.initials: S
authors.lastname: de Silva
authors.forename: J D
authors.initials: JD
authors.lastname: Cartledge
mesh_terms: D000554:Ambulatory Care Facilities; D004196:Disease Outbreaks / Q000517:prevention & control*; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D018451:Homosexuality, Male; D006801:Humans; D008131:London / Q000453:epidemiology; D008219:Lymphogranuloma Venereum / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data