Ongoing Sexually Transmitted Disease Acquisition and Risk-Taking Behavior Among US HIV-Infected Patients in Primary Care: Implications for Prevention Interventions

• Type of Material: Article
• Authors: Kenneth H Mayer, Brown University; Timothy Bush, Centers for Disease Control and Prevention; Keith Henry, Hennepin County Medical Center; Turner Overton, Washington University; John Hammer, Rose Medical Center; Jean Richardson, University of Southern California; Kathy Wood, Cerner Corporation; Lois Conley, Centers for Disease Control and Prevention; John Papp, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Angela Caliendo, Emory University; Pragna Patel, Emory University; John T. Brooks, Emory University
• Language: English
• Date: 2012-01-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © Ovid Technologies, Inc., and its partners and affiliates. All Rights Reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/OLQ.0b013e31823b1922
• Title of Journal or Parent Work: Sexually Transmitted Diseases
• ISSN: 0148-5717
• Volume: 39
• Issue: 1
• Start Page: 1
• End Page: 7
• Grant/Funding Information: Financial support was received from Centers for Disease Control and Prevention contracts 200-2002-00610; 200-2002-00611; 200-2002-00612; 200-2002-00613; 200-2007-23633; 200-2007-23634; 200-2007-23635; and 200-2007-23636.; This work was supported in part by the Emory Center for AIDS research (P30 AI050409).
• Keywords: UNITED-STATES; BISEXUAL MEN; VIRAL LOAD; Infectious Diseases; Science & Technology; Life Sciences & Biomedicine; VIRUS; SEX; HOMOSEXUAL-MEN; SYPHILIS; ACID AMPLIFICATION TESTS; SAN-FRANCISCO; PROBABILITY SAMPLE
• Research Categories: Health Sciences, Medicine and Surgery; Biology, Virology; Health Sciences, Public Health

Abstract

Background: To better understand the factors associated with HIV-and sexually transmitted disease (STD)-transmitting behavior among HIV-infected persons, we estimated STD prevalence and incidence and associated risk factors among a diverse sample of HIV-infected patients in primary care. Methods: We analyzed data from 557 participants in the SUN Study, a prospective observational cohort of HIV-infected adults in primary care in 4 US cities. At enrollment and 6 months thereafter, participants completed an audio computer-assisted self-interview about their sexual behavior, and were screened for genitourinary, rectal, and pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections by nucleic acid amplification testing, and for serologic evidence of syphilis. Women provided cervicovaginal samples and men provided urine to screen for Trichomonas vaginalis by polymerase chain reaction. Results: Thirteen percent of participants had a prevalent STD at enrollment and 7% an incident STD 6 months later. The most commonly diagnosed infections were rectal chlamydia, oropharyngeal gonorrhea, and chlamydial urethritis among the men and trichomoniasis among the women. Other than trichomoniasis, 94% of incident STDs were identified in men who have sex with men. Polysubstance abuse other than marijuana, and having ≥4 sex partners in the 6 months before testing were associated with diagnosis of an incident STD. Conclusions: STDs were commonly diagnosed among contemporary HIV-infected patients receiving routine outpatient care, particularly among sexually active men who have sex with men who used recreational drugs. These findings underscore the need for frequent STD screening, prevention counseling, and substance abuse treatment for HIV-infected persons in care.