New sexually transmitted diseases in HIV-infected patients: markers for ongoing HIV transmission behavior

J Acquir Immune Defic Syndr. 2003 Jun 1;33(2):247-52. doi: 10.1097/00126334-200306010-00021.


Objective: The objective of this study was to describe the rate of new sexually transmitted diseases (STDs) among HIV-infected patients and to define the behavioral and clinical characteristics of HIV-infected patients who return with a new STD in follow-up.

Design: The study design was a record-based clinical cohort study focusing on patients testing HIV-seropositive in the STD clinics of Baltimore, Maryland from 1993 to 1998.

Methods: The authors identified those HIV-infected patients later diagnosed with an STD in follow-up and compared their demographic, behavioral, and clinical characteristics with those who were not diagnosed with an STD in follow-up.

Results: Of 796 men and 354 women with HIV infection, 13.9% of men and 11.9% of women were diagnosed with an STD after their initial HIV diagnosis. HIV-infected men returned with a new STD at a rate of 7 cases per 100 person-years; HIV-infected women returned at a rate of 5.6 cases per 100 person-years. In men, multiple sex partners and sex worker contact were associated with a subsequent STD diagnosis (OR = 1.67, p =.037; OR = 1.82, p =.015, respectively). In women, age younger than 30 years was associated with the diagnosis of an STD after the diagnosis of HIV infection (OR = 2.94, p =.0009).

Conclusions: Patients diagnosed with HIV in an STD clinic setting commonly return with new STDs in follow-up, suggesting continued exposure of HIV to others. More intensive screening and counseling interventions focused on STD prevention in those with HIV infection is a necessary HIV prevention strategy.

Publication types

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

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • Baltimore / epidemiology
  • Cohort Studies
  • Female
  • HIV Seropositivity / complications
  • HIV Seropositivity / epidemiology
  • HIV Seropositivity / transmission*
  • Humans
  • Incidence
  • Male
  • Retrospective Studies
  • Sexual Behavior*
  • Sexual Partners
  • Sexually Transmitted Diseases / complications
  • Sexually Transmitted Diseases / diagnosis*
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases, Bacterial / complications
  • Sexually Transmitted Diseases, Bacterial / diagnosis
  • Sexually Transmitted Diseases, Bacterial / epidemiology
  • Trichomonas Vaginitis / complications
  • Trichomonas Vaginitis / diagnosis
  • Trichomonas Vaginitis / epidemiology