Risk factors associated with incident sexually transmitted infections in HIV‐positive patients in the Australian HIV Observational Database: a prospective cohort study

Abstract

Background We established a sub-cohort of HIV positive individuals from ten sexual health clinics within the Australian HIV Observational Database (AHOD). The aim of this paper was to assess demographic and other factors that might be associated with an incident sexually transmitted infection (STI). Methods The cohort follow-up was from March 2010 to March 2013, and included patients screened at least once for an STI. We used survival methods to determine time-to first new and confirmed incident STI infection (chlamydia, gonorrhoea, syphilis or genital warts). Factors evaluated included sex, age, mode of HIV exposure, year of AHOD enrolment, hepatitis B or C coinfection, time-updated CD4 cell count, time-updated HIV RNA viral load, and prior STI diagnosis. Results There were 110 first incident STI diagnoses observed over 1015 person-years of follow-up, a crude rate of 10.8 (95% confidence interval [CI]:9.0-13.0) per 100 person-years. Factors independently associated with increased risk of incident STI included younger age (≥50 vs 30-39 years old, adjusted hazards ratio, [aHR]=0.4; 95% CI:0.2-0.8, p<0.0001); prior STI infection, (aHR=2.5; 95% CI: 1.6-3.8, p<0.001); and heterosexual vs men who have sex with men (MSM) as likely exposure (aHR=0.2; 95% CI: 0.1-0.6; p<0.001). Conclusions In this cohort of individuals being treated with anti-retroviral drugs (ARV), who are MSM, 30-39 years old, and with a prior history of STI, are at highest risk of a further STI diagnosis

Sexually transmitted infections in young people and factors associated with HIV coinfection: an observational study in a large city

“…In fact, our results show a statistically non-significant decrease in incidence of HIV in MSM in the last few years. Moreover, HIV carriers are vulnerable to new STIs, especially MSM,32 young people7 12 and those who had a previous history of STI 32. Also, the greater risk associated with a higher number of sexual partners found in the multivariate analysis is consistent with previous reports 7 26.…”

Risk factors associated with sexually transmitted infections and HIV among adolescents in a reference clinic in Madrid

“…In our study, 9%-22% had their first sexual relations before the age of 14, according to sexual behavior. Beginning sexual relations at a young age, especially at 13 or younger, and the presence of a history of STIs are factors which have been independently associated with the presence of HIV/STIs, as has also been reported in other publications [26]. These indicators, found in our study, can help establish specific prevention programs in this age group.…”

&lt;i&gt;Syphilis&lt;/i&gt; and &lt;i&gt;Chlamydia trachomatis&lt;/i&gt; in Males from Northern Mexico with HIV-AIDS

“…In a study conducted in the United Kingdom in 2011, the authors described a frequency of CT infection of 12.4% and 5.5% for NG [21]. These results are very similar to those described in an Australian population, in which the frequency was 10.8% for CT, 5.3% for syphilis and 7.1% for NG [15] (15). The frequencies of CT and NG infections in this study were lower than those found in these populations, with only 2% and 0%.…”

“…Alternatively, people infected with HIV are more susceptible to other STIs, since they are immunosuppressed and less able to develop an adequate response to sexually transmitted pathogens [8,11]. Therefore, as described by other authors, the prevalence of co-infection between some STIs and HIV is 14%, particularly in the group of men who have sex with men (MSM) [12][13][14][15][16].…”