title: The rising trend of sexually transmitted infections among HIV-infected persons: a population-based cohort study in Taiwan, 2000 through 2010.
abstract: OBJECTIVE
  Positive prevention interventions for patients living with the HIV include the early detection and treatment of sexually transmitted infections (STIs). This study aimed to determine the incidence of selected STIs, including syphilis, genital warts, gonorrhea, chlamydial infection, and trichomoniasis, in a population-based cohort of individuals living with HIV.
  
  
  METHODS
  Clinical data from 2000 to 2010 were obtained from the Taiwan National Health Insurance Research Database identified 15,123 patients with HIV infection. The incidence rates were standardized by age and sex using the direct method that was based on the 2000 World Health Organization world standard population.
  
  
  RESULTS
  The overall rate ratio of STI episodes significantly increased [rate ratio: 34.0, 95% confidence interval (CI): 24.3 to 47.6, P < 0.01]. After an HIV diagnosis, 15.9% of patients with HIV had at least 1 of these 5 STIs. An incidence rate of 503.0 STI episodes/10,000 person-years (PYs) (95% CI: 487.1 to 519.5) was detected during the 11-year follow-up period. The most common STIs after an HIV diagnosis were syphilis (381.9 episodes/10,000 PYs; 95% CI: 368.0 to 396.3), followed by genital warts (138.9 episodes/10,000 PYs; 95% CI: 130.6 to 147.6). The incidence of STIs varied significantly according to gender. In women, the annual incidence of STIs remained stable. However, the annual incidence of syphilis, genital warts, and chlamydial infection increased in young men.
  
  
  CONCLUSIONS
  An increase in STIs among HIV-positive persons highlights the need to identify the causal factors of these co-infections. Routine STI screenings and early preventive interventions against STIs in HIV-infected persons are crucial.
authors.affiliation: Departments of *Nursing; †Institute of Allied Health Sciences, ‡Public Health, ‖Medicine, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan; and §Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Yen-Chin
authors.initials: YC
authors.lastname: Chen
authors.forename: Hsiao-Ying
authors.initials: HY
authors.lastname: Liu
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
authors.forename: Nan-Yao
authors.initials: NY
authors.lastname: Lee
authors.forename: Chia-Wen
authors.initials: CW
authors.lastname: Li
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
authors.forename: Nai-Ying
authors.initials: NY
authors.lastname: Ko
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology*; D003218:Condylomata Acuminata / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D014245:Trichomonas Infections / Q000453:epidemiology*; D055815:Young Adult