HIV seropositivity among patients with sexually transmitted diseases

2013 patients with various sexually transmitted diseases were screened for HIV antibodies in voluntary counseling and testing centre (VCTC) attached to Microbiology Lab of Govt. Medical College, Amritsar from Jan. 1998 to Dec. 2001. Sixty-one (3.03%) were found to be positive for HIV. 44 were males and 17 were females. There was a constant rise in the percentage positivity in females from 14.3% in 1998 to 38.09% in 2002. There was also rise in the prevalence of HIV among the STD attenders (1.65% in 1998 to 5.13% in 2001).     

Intravaginal practices, HIV and other sexually transmitted diseases among South African women

BACKGROUND AND OBJECTIVES: Intravaginal practices, including wiping, douching, or inserting substances into the vagina, have been hypothesized to increase women's risk of HIV infection. However, data on the prevalence of these practices, and associations with HIV and other sexually transmitted diseases (STD), are limited. STUDY DESIGN: We interviewed 2,897 women participating in a gynecologic screening study in Cape Town, South Africa, about their intravaginal practices. After clinical examination, cervical and blood samples were collected and tested for HIV and other STD [corrected]. RESULTS: Of the 831 (29%) women reporting some type of intravaginal practice, 48% reported using only water and cloth to clean inside the vagina, whereas 17% reported using antiseptics or detergents. Most women (53%) reported practices as part of regular hygiene. Intravaginal practices were strongly associated with behavioral risk factors, and recent multiple sexual partners [corrected]. Intravaginal practices were associated with prevalent HIV infection (adjusted odds ratio, 1.74; 95% confidence interval, 1.37-2.20), but were not associated with other STDs. CONCLUSION: Prospective studies that include detailed measurements of correlated sexual risk behaviors are required to discern whether this association is causal in nature; if so, these behaviors could represent an important area for future HIV prevention interventions.     

Tracing contacts of persons with sexually transmitted diseases in a developing country

A simplified system for tracing of contacts of patients suffering from sexually transmitted diseases is presented. Use of a contact card given to the index case led 341 contacts (19.8%) to attend a clinic for treatment voluntarily. Visits to the homes of contacts who did not bring their cards to the clinics were made by health assistants employed by the local health department. After being traced in this manner, a further 367 contacts (21.3%) were seen. No substantial cost was borne by the department, and the exercise did not necessitate the employment of additional staff.     

Incident sexually transmitted infections among persons living with diagnosed HIV/AIDS in New York City, 2001-2002: a population-based assessment

OBJECTIVE/GOAL: To describe the incidence of 3 bacterial sexually transmitted infections (STIs) among persons living with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) (PLWHA) in New York City (NYC) and to identify predictors for STI acquisition. STUDY DESIGN: The surveillance registry of PLWHA diagnosed with HIV through December 31, 2000, and reported to the NYC Department of Health and Mental Hygiene was matched with the surveillance registry of persons diagnosed with other STIs during 2001-2002. Incident STIs were defined as cases of gonorrhea, chlamydia, or early syphilis acquired after HIV diagnosis. RESULTS: Among 62,264 NYC PLWHA, 1466 (2.4%) had an incident STI diagnosed during 2001-2002. Two-year cumulative STI incidence was highest among PLWHA who were men (2.6%), non-Hispanic white (3.2%), aged 13-24 years (8.4%), men who have sex with men (4.5%), and persons living with HIV (non-AIDS) (4.1%). Predictors of STI acquisition among PLWHA varied substantially by STI type. CONCLUSIONS: This population-based surveillance registry cross-match reveals that high-risk sexual practices occur among specific segments of the NYC PLWHA population. To decrease associated morbidity and prevent the secondary spread of HIV and STIs, prevention efforts should focus on PLWHA who continue to engage in high-risk sexual activity.     

New sexually transmitted infections among adolescent girls infected with HIV

OBJECTIVES: Although the prevalence of sexually transmitted infections (STIs) among girls infected with HIV has been reported, the incidence of STI diagnoses has not been well documented. The objectives of this study were to examine (1) incident STI diagnoses and (2) the association between viral load (VL) and incident STI diagnosis among HIV-infected adolescent girls in care. METHODS: This was a prospective longitudinal 18-month study of girls enrolled in the Adolescent HIV trials network. Cox proportional hazard modelling was performed to evaluate the incidence of STI by baseline viral load. RESULTS: The mean (SD) age of participants was 20.6 (2.0) years, viral load of participants was 66,917 (165,942) copies/ml and median viral load was 7,096 copies/ml. The incidence of STIs for the entire cohort was 1.4 per 100 person-months. During the 18-month follow-up period, there were no significant differences in the STI incidence between the high and low viral load groups (hazard ratio (HR) = 0.86, 95% CI 0.37 to 1.95) There was also no significant association between STI incidence and log-transformed viral load (HR = 1.10, 95% CI 0.92 to 1.3). CONCLUSIONS: Adolescent girls with HIV infection continue to acquire sexually transmitted infections after diagnosis. This analysis does not suggest that VL is a critical factor in STI acquisition over time. Additional work exploring the role of other contextual factors on STI acquisition among HIV-infected adolescent girls is warranted.     

Selected sexually transmitted diseases and their relationship to HIV

Although sexually transmitted diseases (STDs) are underreported and underrecognized, they are a major source of morbidity, mortality, and represent a major socioeconomic cost in developing and industrialized nations. Individuals who develop STDs are often coinfected with human immunodeficiency virus (HIV). Coinfection with HIV both facilitates the natural history of STDs and worsens the clinical picture. The objective of this article is to provide a review to the practicing clinician on the epidemiology, clinical manifestations, methods of diagnosis, and treatment for four cutaneous STDs—chancroid, genital herpes, granuloma inguinale, and lymphogranuloma venereum—in coinfected HIV patients.     

Needs assessment for STD/HIV prevention among patients with sexually transmitted diseases in southern China

BACKGROUND AND GOAL: Patients with sexually transmitted diseases (STDs) serve as a bridge population to transmit HIV from higher-risk to lower-risk populations. Our goal was to understand the level of risk behaviors and HIV/STD-related knowledge as well as attitudes among STD patients in China. STUDY DESIGN: An anonymous questionnaire was self-administered by 619 STD patients in Guangzhou, China. RESULTS: About 70% of the males and 18% of the females had had sex with nonregular sex partners in the previous 6 months; the prevalence of consistent condom use was very low (20% for males and 10% for females). Only 20% to 30% of the respondents stated that they would not practice unprotected sex with nonregular sex partners before their STD was cured. Misconceptions about STD/HIV are very common. STD/HIV-related knowledge, perceived susceptibility of contracting HIV, and perceived efficacy of condom use for HIV/AIDS prevention were significantly associated with anticipated or actual risk behaviors during the infectious period. CONCLUSION: Intervention programs are in urgent need to break the cycle of STD infection in China. These would include promotion of relevant knowledge, condom use, and public education.     

Characteristics of gay persons with sexually transmitted disease

Two hundred sixty-one male homosexuals and one hundred four female homosexuals completed questionnaires dealing with patterns of sexual activity and experience with sexually transmitted diseases. Among lesbians, a history of gonorrhea or syphilis was associated with heterosexual activity. Among gay males, gonorrhea and syphilis were associated with white race, residence in an urban area, low income, and high scores on the Brief Michigan Alcoholism Test. Male homosexuals had more episodes of gonorrhea and syphilis than did female homosexuals. Among male homosexuals the number of sex partners was greater among young urban residents. Poor health practices with respect to sexually transmitted diseases (i.e., delay in seeking treatment, self-treatment, and lack of regular check-ups) were more common among the older, less-well educated, and nonurban groups of gay males.     

Prevalence and predictors of sexually transmitted infection among newly incarcerated females

OBJECTIVES: To examine demographic and behavioral characteristics in incarcerated women to determine which characteristics are associated with prevalent sexually transmitted infections (STIs). STUDY DESIGN: A cross-sectional analysis of data of 205 women entering jail in Rhode Island was performed as part of a study evaluating a family planning program. Women were recruited near time of commitment, and inclusion was limited to women at risk for an unplanned pregnancy. Incarcerated women were interviewed by a research assistant for demographic information, psychosocial and behavioral characteristics. Self-collected vaginal swabs were tested for STIs, including Neisseria gonorrhoeae and Chlamydia trachomatis by polymerase chain reaction and Trichomonas vaginalis by InPouch culture. Relative risks (RRs) were estimated using Poisson regression. RESULTS: Sixty-eight of 205 patients tested positive for an STI [33%; 95% confidence interval (CI) 27-40%]. Forty-five patients (26%) tested positive for T. vaginalis, 27 (14%) were positive for C. trachomatis, and 21 (11%) were positive for N. gonorrhoeae. On bivariate analysis, 6 or more sexual partners in the last year (RR 1.84; 95% CI 1.01-3.36), exchanging sex for drugs/money (RR 1.65; 95% CI 1.01-2.69), and homelessness (RR 1.82; 95% CI 1.07-3.09) were associated with STI. After adjustment for age, race/ethnicity, education, and other covariates, none of the factors was significantly associated with STI. CONCLUSIONS: The prevalence of STI in this jail population is high. Incarceration represents a unique opportunity to evaluate and treat this underserved population. Predictors of infection are limited and infection is common; therefore, routine screening should be considered in this population.     

HIV infection--a sexually transmitted disease

In the light of literature reports and own experiences and observations the most important epidemiological aspects of HIV infection acquired through sexual contacts are discussed, including the likelihood of infection during heterosexual or homosexual intercourse, factors increasing the infection risk in homosexuals intercourse and the more or less safe forms of sexual intercourse. The combination of HIV infections with infections with other sexually transmitted diseases is discussed on the basis of own observations which showed that HIV infection was acquired much more frequently by homosexuals treated in outpatient clinics for venereological diseases (19.7%) as compared to other homosexual groups (2.7%), and the risk was even lower in heterosexuals treated in these clinics for sexually transmitted diseases (0.2%). Over half the patients infected with HIV had or had had syphilis. HIV infection was sought for in Warsaw prostitutes, and 0.6% of them were found to be infected, two-thirds of the infected ones were drug addicted prostitutes. The importance of the sexual route of infection in drug addicts and transmission of this infection to the heterosexual population are considered. The principles of prophylaxis, the directions of health education, and the importance of screening for HIV infection prevention are considered. Attention is called to the harmful effects of all types of restriction of the infected people which lead to trials of infection concealment.     

HBsAg and sexually transmitted diseases

HBsAg was studied in 50 patients of STD's and promiscuous persons. In 10.52% cases it was positive. Vaccination against Hepatitis-B was recommended in promiscuous individuals.     

Acceptance of hepatitis B vaccination among adult patients with sexually transmitted diseases.

BACKGROUND: Sexually transmitted disease (STD) clinic patients are at risk for hepatitis B virus infection, but have been relatively neglected in terms of hepatitis B virus (HBV) immunization. Acceptance of HBV vaccine among patients attending an STD clinic was examined. GOAL: To evaluate potential predictors of HBV vaccine acceptance. STUDY DESIGN: In this study, 99 patients attending an STD clinic completed a brief questionnaire that addressed knowledge of STD and vaccines as well as sexual behavior. After the questionnaire, each patient was offered HBV vaccine, then interviewed to assess reasons for acceptance or refusal. RESULTS: Among the patients in this study, 23% accepted the vaccine and 11% reported prior vaccination. Acceptors were younger, had less education, and used condoms less frequently than those who refused vaccination. The reasons given for acceptance or rejection typically involved health beliefs related to infection or vaccination. CONCLUSION: The findings indicate an unacceptably low rate of HBV vaccine acceptance in a group at high risk for infection. However, some of the reasons for refusal may be modifiable through brief, targeted interventions.