Clinical and demographic trends in a sexually transmitted infection clinic in Mumbai (1994-2006): an epidemiologic analysis.
BACKGROUND
People presenting to sexually transmitted infections (STIs) clinics represent an important risk group for HIV infection; prevention strategies will depend on the clinical attendance.


OBJECTIVE
The demographic and clinical changes in clinic attendees in Mumbai, as well as the factors associated with HIV infection in this clinic over a 13-year period, were assessed.


METHODS
STI clinic data in 3417 individuals (1994 to 2006) were analyzed: clinical presentation, types of STIs, and serology over the 13-year period. We used a logistic regression model to assess socio-demographic and clinical associations with HIV infection.


RESULTS
The clinic evaluated 689 patients in 1994 and the number had dropped to 97 in 2006. In 1994, the majority of STIs seen in the clinic were bacterial (53%, 95% confidence interval [CI] 50% to 57%); however, this proportion had dropped in 2006 (28%, 95% CI: 19% to 38%). There was a proportional increase in viral STIs during the same time period. Although women attending the clinic were younger than men, they were more likely to be married. The overall seropositivity for HIV was 28%. Viral STIs were more likely to be associated with HIV than bacterial infections (odds ratio: 1.5, 95% CI: 1.2 to 1.9).


CONCLUSIONS
Viral infections were the most common STIs in recent years in a tertiary care center in Mumbai. HIV prevalence was high in this population. Thus, these clinical data suggest that STI patients were and continue to be an important group for HIV prevention in the country.
Setia
Maninder S
MS
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada. maninder.setia@mail.mcgill.ca
Jerajani
Hemangi R
HR
Brassard
Paul
P
Boivin
Jean-Francois
JF
D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology*; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult