Risk for HIV following a diagnosis of syphilis, gonorrhoea or chlamydia: 328,456 women in Florida, 2000-2011.
Several effective interventions are available for preventing HIV in women. Targeting interventions requires understanding their risk of acquiring HIV. We used surveillance data to estimate risks of HIV acquisition for 13-59-year-old women following a diagnosis of syphilis, gonorrhoea or chlamydia in Florida during 2000-2009. We excluded women reported with HIV before their STI, and measured HIV reported subsequent to STI (through 2011). Rates were compared to women with no reported STI. A total of 328,456 women had: syphilis (3325), gonorrhoea (67,784) or chlamydia (257,347). During 2,221,944 person-years of follow-up, 2118 of them were diagnosed with HIV. For women with no STI reported, during 64,763,832 person-years, 19,531 were reported with HIV. The crude rate of subsequent HIV diagnosis (per 100,000 person-years) was higher for women diagnosed with syphilis (597.9), gonorrhoea (171.3) or chlamydia (66.3) than women with no STI (30.2). Annual rates of HIV decreased over-all by 61.8% between 2001 and 2011. Women with syphilis or gonorrhoea were at highest risk for HIV and therefore might benefit from intensive counselling. However, they represented only a small fraction of the women who acquired HIV. Most cases of HIV infection among women occurred among the large group of women who were not at highest risk.
Division of STD Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA tap1@cdc.gov.
Thomas A
TA
Peterman
Division of STD Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Daniel R
DR
Newman
Florida Department of Health, Division of Disease Control and Health Protection, Tallahassee, FL, USA.
Lorene
L
Maddox
Florida Department of Health, Division of Disease Control and Health Protection, Tallahassee, FL, USA Florida State University, College of Nursing, Tallahassee, FL, USA.
Karla
K
Schmitt
Florida Department of Health, Division of Disease Control and Health Protection, Tallahassee, FL, USA.
Stacy
S
Shiver
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005431:Florida / Q000453:epidemiology; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology; D013587:Syphilis / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
AIDS; HIV; HIV incidence; North America; chlamydia; epidemiology; gonorrhoea; prevention; sexually transmitted infection; syphilis; women