Behavioral and biologic evidence of persistent high-risk behavior in an HIV primary care population

AIDS. 2000 Feb 18;14(3):297-301. doi: 10.1097/00002030-200002180-00012.


Objective: To define the prevalence of gonorrhea, chlamydial infection, and high-risk sexual behavior in an HIV primary care clinic.

Design: Subjects enrolling in this cross-sectional study answered a brief interviewer-administered questionnaire and provided a urine sample for gonorrhea and chlamydia testing.

Setting: A large urban HIV primary care clinic.

Participants: HIV-infected patients presenting for a scheduled medical visit from June 1997 to April 1998.

Main outcome measures: Prevalence of self-reported high-risk sexual behavior and gonorrhea and chlamydial infection.

Results: Of 691 patients consenting to the study over a 10-month period, 58% reported sexual activity in the past 90 days, 7.4% reported multiple sexual partners in the past month, and 34.6% did not use a condom at last sexual encounter. Overall, 4.6% reported a history of either gonorrhea or a chlamydial infection in the past year. Of 637 giving a urine sample for testing, the prevalence of chlamydial infection was 2.4%; the prevalence of gonorrhea was 1.6%. Overall, 7.5% of those screened had either current or recent (within 1 year) gonorrhea or chlamydial infection. Current or recent gonorrhea or chlamydial infection was not associated with age, gender, HIV transmission risk, CD4 cell count, HIV viral load, symptoms, or self-reported risk behavior.

Conclusion: High-risk sexual behavior and unrecognized sexually transmitted diseases (STD) are common among HIV-infected persons followed in primary medical care. Enhanced detection of treatable STD among this population coupled with improved risk-reduction counselling may be important clinical practice measures that can curb the spread of HIV.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Chlamydia Infections / complications
  • Female
  • Gonorrhea / complications
  • HIV Infections / psychology*
  • Humans
  • Male
  • Primary Health Care
  • Risk-Taking*
  • Sexual Behavior*
  • Urban Population