Human Immunodeficiency Virus Infection among Patients Attending Clinics for Sexually Transmitted Diseases

Abstract

To assess the prevalence and associated risk factors for human immunodeficiency virus (HIV) infection in patients attending inner-city clinics for sexually transmitted diseases in Baltimore, we screened 4028 patients anonymously, of whom 209 (5.2 percent) were seropositive for HIV. HIV-seropositivity rates were higher among men (6.3 percent) than women (3.0 percent) (P less than 0.001) and among blacks (5.0 percent) than whites (1.2 percent) (P less than 0.02). Among men, but not women, HIV seroprevalence increased markedly and steadily up to the age of 40. In men, HIV seropositivity was independently associated with increased age, black race, a history of homosexual contact, and the use of parenteral drugs. In women, a history of parenteral drug use or of being a sexual partner of a bisexual man or parenteral drug user were independently predictive of HIV seropositivity. In men, HIV seropositivity was also associated with a history of syphilis or a reactive serologic test for syphilis, and in women, with a history of genital warts. Since these associations were independent of the type and number of reported sexual partners, they raise the possibility that sexually transmitted diseases that disrupt epithelial surfaces may be important in the transmissibility of HIV. In addition, on a self-administered questionnaire, one third of HIV-infected men and one half of infected women did not acknowledge previous high-risk behavior for HIV exposure. These data suggest that patients at clinics for sexually transmitted diseases represent a group at high risk for HIV infection, and that screening, counseling, and intensive education should be offered to all patients attending such clinics.

Sperm Characteristics and Accessory Sex Gland Functions in Hiv-Infected Men

“…Strikingly high rates of HIV seropositivity in the presence of STDs have implicated STDs as risk factors for heterosexual transmission [3,22], which is confirmed in the present study, since 80% of HIV-seropositive patients in our study had previous history of STDs. STDs often re-sult in the increased presence of white blood cells in the reproductive fluids of both men and women [1], which is confirmed in the present study.…”

A descriptive study of sexual health attitudes and practices among adolescent and young adult male county health department clients

“…It has been shown that anal intercourse is a very effective sexual practice for the transmission of HIV. This is mostly due to the microscopic tears in the epithelial tissue of the anus and rectum which creates a direct route into the bloodstream (Quinn et al, 1988). Unprotected anal intercourse is one of the major original routes of transmission in the homosexual population infected with the virus.…”

“…A past history of STDs increases the likelihood of being HIV infected. This is due to the fact that a majority of STDs disrupt the epithelial surface, and consequently provides a prime route of HIV transmission (Quinn et al, 1988 or may not know that they are infected at this time, but most likely they will become AIDS patients and die within 8 to 10 years.…”

HIV Infection and AIDS in Children

“…In African cities, seroprevalence rates of 5-30% have been documented among women who attend antenatal clinics (17, 59,67,90,95,105,126,137,142,143). Rates of HIV infection have risen from 0% in 1980 to 3% in (133,134) and seropositivity to herpes simplex virus type II (31), which is the predominant cause of genital herpes, were strongly associated with HIV infection among women with or without a history of IV drug use. Therefore, STDs appear to be intricately linked to HIV epidemiology and represent one of the major explanations for the heterosexual epidemic in central equatorial Africa, and for the increasing number of heterosexual cases in the US.…”