title: High rates of sexually transmissible infections in HIV-positive patients in the Australian HIV Observational Database: a prospective cohort study.
abstract: Background In HIV-positive people, sexually transmissible infections (STIs) probably increase the infectiousness of HIV.
  
  
  
  In 2010, we established a cohort of individuals (n=554) from clinics in the Australian HIV Observational Database (AHOD). We calculated retrospective rates for four STIs for 2005-10 and prospective incidence rates for 2010-11.
  
  
  
  At baseline (2010), patient characteristics were similar to the rest of AHOD. Overall incidence was 12.5 per 100 person-years. Chlamydial infections increased from 3.4 per 100 person-years (95% confidence interval (CI): 1.9-5.7) in 2005 to 6.7 per 100 person-years (95% CI: 4.5-9.5) in 2011, peaking in 2010 (8.1 per 100 person-years; 95% CI: 5.6-11.2). Cases were distributed among rectal (61.9%), urethral (34%) and pharyngeal (6.3%) sites. Gonococcal infections increased, peaking in 2010 (4.7 per 100 person-years; 95% CI: 5.6-11.2; Ptrend=0.0099), distributed among rectal (63.9%), urethral (27.9%) and pharyngeal (14.8%) sites. Syphilis showed several peaks, the largest in 2008 (5.3 per 100 person-years; 95% CI: 3.3-8.0); the overall trend was not significant (P=0.113). Genital warts declined from 7.5 per 100 person-years (95% CI: 4.8-11.3) in 2005 to 2.4 per 100 person-years (95% CI: 1.1-4.5) in 2011 (Ptrend=0.0016).
  
  
  
  For chlamydial and gonococcal infections, incidence was higher than previous Australian estimates among HIV-infected men who have sex with men, increasing during 2005-2011. Rectal infections outnumbered infections at other sites. Syphilis incidence remained high but did not increase; that of genital warts was lower and decreased.
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Mulhall
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Wright
authors.affiliation: Holden Street Sexual Health Clinic, PO Box 361, Gosford, NSW 2250, Australia.
authors.forename: Debbie
authors.initials: D
authors.lastname: Allen
authors.affiliation: University of Sydney, Camperdown, NSW 2006, Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Brown
authors.affiliation: Caradata, PO Box 579, Arundel DC, Qld 4214, Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Dickson
authors.affiliation: Clinic 468, Tamworth Sexual Health, Hunter New England Area Health Service, NSW 2340, Australia.
authors.forename: Miriam
authors.initials: M
authors.lastname: Grotowski
authors.affiliation: Nepean/Blue Mountains Sexual Health, Nepean Hospital, Kingswood NSW 2747, Australia.
authors.forename: Eva
authors.initials: E
authors.lastname: Jackson
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Kathy
authors.initials: K
authors.lastname: Petoumenos
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Read
authors.affiliation: Melbourne Sexual Health Centre, Alfred Hospital, Prahran, Vic. 3181, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Read
authors.affiliation: Cairns Sexual Health Service, PO Box 902, Cairns, Qld 4214, Australia.
authors.forename: Darren
authors.initials: D
authors.lastname: Russell
authors.affiliation: Lismore Sexual Health Services, 4 Shepherd Lane, Lismore, NSW 2480, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Smith
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Templeton
authors.affiliation: Melbourne Sexual Health Centre, Alfred Hospital, Prahran, Vic. 3181, Australia.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Law
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D002690:Chlamydia Infections / Q000175:diagnosis; D003218:Condylomata Acuminata / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D000072339:Sexual and Gender Minorities; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D013587:Syphilis / Q000453:epidemiology
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