HIV status and viral loads among men testing positive for rectal gonorrhoea and chlamydia, Maricopa County, Arizona, USA, 2011–2013

Abstract

Objectives Men diagnosed with rectal gonorrhoea (GC) and chlamydia (CT) have engaged in unprotected receptive anal intercourse. We reviewed the HIV positivity and HIV viral loads (VLs) of men who had rectal GC and CT testing to evaluate potential HIV acquisition and transmission risk. Methods Rectal GC and CT testing data for men attending the Maricopa County STD clinic during the period from 1 October 2011 to 30 September 2013 were cross-matched with HIV surveillance data to identify men with HIV coinfection. We examined HIV status, HIV diagnosis date, and the values of VL collected nearest to the date of reported rectal infection. Results During the 2-year time period, 1591 men were tested for rectal GC and CT. Of the men tested, 506 (31.8%) were positive for GC (13.2%), CT (12.2%) or both (6.4%); 119 (23.5%) of those with rectal GC or CT were coinfected with HIV. Among the 275 men with HIV at the time of rectal testing, 54 (19.6%) had no reported VL; 63 (22.9%) had an undetectable VL (< 20 HIV-1 RNA copies/mL) and 158 (57.4%) had a detectable VL collected within 1 year of rectal diagnosis. Mean VL was higher among HIV and rectal GC/CT coinfected cases compared with men with HIV alone (174 316 vs. 57 717 copies/mL, respectively; P = 0.04). Conclusions Approximately one-third of men undergoing rectal testing were positive for GC or CT and one-quarter of men with rectal GC or CT also had HIV infection. Of the HIV-infected men tested for rectal GC or CT, more than half had a detectable VL collected near the time of rectal testing, demonstrating a risk for transmitting HIV.

HIV-1-Syphilis Co-infection Associated with High Viral Load in Female Sex Workers in the Democratic Republic of the Congo

“…27,28 In addition, Rwandan FSWs use condoms less and are usual victims of sexual and physical violence. 29 The mean HIV-1 VL in HIV-positive FSWs was higher in those co-infected with syphilis than those who were not, similar to the findings of de Almeida et al 30 and Taylor et al 31 Nevertheless, there were no significant differences in HIV-1 VL according to: age (p = 0.469); duration in the sex profession (p = 0.454); or level of education (p = 0.589). Conversely, co-infected FSWs had higher VLs than HIV+ without syphilis (p = 0.012).…”

Gonorrhoea: a systematic review of prevalence reporting globally

“…In five studies, men testing HIV-positive were excluded at the outset [ 96 , 119 , 124 , 148 , 149 ]. HIV status was reported in five studies with variable HIV-positivity [ 98 , 100 , 103 , 115 , 127 ]. Three studies included asymptomatic cases only [ 120 , 131 , 150 ].…”

Gaps Along the HIV Care Continuum: Findings Among a Population Seeking Sexual Health Care Services in New York City

“…Previous analyses comparing medical record and HIV surveillance data in NYC, however, have found high (>85%) agreement between the two, particularly for retention in care measures [9, 15]. Third, our VL measure using the last test in the year after SHC visit may not reflect viral suppression status at the time of the visit; given possible spikes in VL associated with STI [16, 17], it would be important to know about VL on DOV, which has implications for HIV transmissibility. Finally, findings on HIV care continuum outcomes among our study population of HIV-positive patients seeking sexual health care may not be generalizable to other patient populations.…”