High Prevalence of Sexually Transmitted Infections in HIV-infected Men During Routine Outpatient Visits in the Netherlands

Sex Transm Dis. 2012 Jan;39(1):8-15. doi: 10.1097/OLQ.0b013e3182354e81.

Abstract

Background: In the Netherlands, no guidelines exist for routine sexually transmitted infection (STI) screening of human immunodeficiency virus (HIV)-infected men having sex with men (MSM). We assessed prevalence and factors associated with asymptomatic STI.

Methods: MSM visiting HIV outpatient clinics of academic hospitals were tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), syphilis, and hepatitis B and C infection. Prevalence and risk factors were studied using logistic regression.

Results: In total, 659 MSM were included between 2007 and 2008. STI were found in 16.0% of patients, mostly anal CT and syphilis. One new hepatitis B and 3 new hepatitis C infections were identified. In multivariate analyses, any STI (syphilis, CT, or NG) was associated with patient's age below 40 years (odds ratio [OR]: 2.5, 95% confidence interval [CI]: 1.3-5.0), having had sex with 2 or more sexual partners (OR 2.1, 95% CI: 1.2-3.5), the use of the same sexual toys with a sexual partner (OR 2.2, 95% CI: 1.0-4.9), and enema use before sex (OR: 2.3, 95% 1.2-4.2). Syphilis was independently associated with fisting with gloves versus no fisting (OR: 4.9, 95% CI: 1.7-13.7) and with rimming (OR: 5.0, 95% CI: 1.7-15.0). CT or NG were associated with age below 45 years (age 40-44 years: OR: 2.4, 95% CI: 1.1-5.3; age <40 years: OR: 2.4, 95% CI: 1.1-5.4), enema use before sex (OR: 2.4, 95% CI: 1.3-4.4) and drug use during sex (OR: 2.4, 95% CI: 1.4-4.0).

Conclusions: High-risk sexual behavior was very common, and 16% of HIV-infected MSM in HIV care had an asymptomatic STI, mostly anal CT and syphilis. Development of STI screening guidelines is recommended.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asymptomatic Diseases
  • Chlamydia Infections / complications
  • Chlamydia Infections / diagnosis
  • Chlamydia Infections / epidemiology*
  • Chlamydia trachomatis / isolation & purification*
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • Hepatitis B / complications
  • Hepatitis B / diagnosis
  • Hepatitis B / epidemiology
  • Hepatitis C / complications
  • Hepatitis C / diagnosis
  • Hepatitis C / epidemiology
  • Homosexuality, Male
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Outpatients
  • Prevalence
  • Risk Factors
  • Sexual Behavior
  • Sexually Transmitted Diseases / complications
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / epidemiology*
  • Syphilis / complications
  • Syphilis / diagnosis
  • Syphilis / epidemiology*
  • Treponema pallidum / isolation & purification