The three-year positivity rate of sexually transmitted infections among a group of HIV-infected men attending the Department of Genitourinary Medicine, Edinburgh, UK

Manavi, K; Luo, Peifang; McMillan, A

doi:10.1258/095646205774763144

Cited by 5 publications

(5 citation statements)

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“…The majority (nine of 14; 64%) were asymptomatic, showing that the diagnosis would not have been achieved without screening. Similar high rates of chlamydia have been seen in other HIV‐infected cohorts , although in our patients the main site of infection was in the urethra as opposed to a higher prevalence of rectal infections seen in other cohorts . The size of the increase in diagnosed chlamydia was also unusual in that we saw chlamydia infections increase by 100% between 2010–2011 and 2011–2012, which is far greater than the national trend of a 10% increase per year in MSM .…”

Section: Discussionsupporting

confidence: 79%

Retrospective study of the effect of enhanced systematic sexually transmitted infection screening, facilitated by the use of electronic patient records, in an HIV‐infected cohort

2013

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Objectives The aim of the study was to assess the impact of electronic checklists in enhancing sexually transmitted infection (STI) screening in routine HIV care. Methods This was a retrospective cohort study. In two HIV clinics, new STIs were recorded for three consecutive 12‐month periods between 2009 and 2012 in a cohort of 882 HIV‐infected patients. These three years coincided with the introduction of enhanced STI screening based on prompts within the electronic patient record (EPR) system. Results The number of diagnoses and the incidence of STIs more than doubled between 2010–2011 and 2011–2012 in both men who have sex with men (MSM) [from 18 of 115 (15%) to 42 of 132 (32%), a rise in STI incidence from 15.6 to 31.8/100 person‐years; P < 0.001] and heterosexual patients [from six of 716 (0.8%) to 19 of 749 (2.5%), a rise in STI incidence from 0.8 to 2.5/100 person‐years; P < 0.005]. The rise was significant in MSM for infections with chlamydia [from seven of 115 (6%) to 14 of 132 (11%), a rise in incidence from 6.0 to 10.6/100 person‐years; P < 0.05], gonorrhoea [from five of 115 (4%) to 12 of 132 (9%), a rise in STI incidence from 4.3 to 9.1/100 person‐years; P < 0.05] and early syphilis [from four of 115 (3%) to 13 of 132 (10%), a rise in incidence from 3.5 to 9.8/100 person‐years; P < 0.001], but not for hepatitis C virus (HCV) and Lymphogranuloma venereum (LGV) infections. The rise was significant in heterosexual patients for infection with chlamydia [from four of 716 (0.6%) to 13 of 749 (1.7%), a rise in incidence from 0.6 to 1.7/100 person‐years; P < 0.0001] but not for gonorrhoea, syphilis or Trichomonas vaginalis (TV). Conclusions These data show that implementing systematic, frequent and routine STI screening led to a large increase in detected STIs in this HIV‐infected cohort. This process is greatly enhanced by the use EPRs.

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Section: Discussionsupporting

confidence: 79%

Retrospective study of the effect of enhanced systematic sexually transmitted infection screening, facilitated by the use of electronic patient records, in an HIV‐infected cohort

2013

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“…However, most studies were hampered by nonstandardized procedures, and were unable to examine risk factors for STIs. There have been very few studies that have been designed to measure the incidence of STIs accurately, or that have collected data on sexual behaviours, drug use and the use of ARVs .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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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

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“…5,6 Factors associated with incident STIs among HIV-infected adults included higher CD4+ T-cell (CD4) count, 7 and current antiretroviral therapy (ART) and lower VL (among men). 8 One previous study examined STI incidence among HIV-infected adolescent women over an 18-month period. 9 However, because adolescents are at high risk for STIs, comparing incidence rates between HIV-infected and HIV-uninfected adolescents is necessary to determine differences in risk factors between these populations and whether STI incidence may be associated with HIV-infection related factors such as CD4 count, VL, disease stage, and/or ART.…”

Section: Introductionmentioning

confidence: 99%

Incidence of sexually transmitted infections in HIV-infected and HIV-uninfected adolescents in the USA

et al. 2013

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Summary Little is known about the incidence of bacterial sexually transmitted infections (STIs) among HIV-infected vs. HIV-uninfected adolescents. This secondary analysis of a national, multisite study included adolescents aged 12–18 years who were behaviorally HIV-infected (n=346) or HIV-uninfected but at-risk (n=182). Incidence rates of bacterial STIs (gonorrhea, chlamydia [CT], and trichomonas [TV; females]) were calculated using Poisson modeling. Factors associated with incident STIs were explored using Cox proportional hazards modeling. HIV-infected vs. HIV-uninfected women had higher TV incidence (1.3 vs. 0.6/100 person-months; p=0.002). HIV-uninfected vs. HIV-infected women had higher CT incidence (1.6 vs. 1.1/100 person-months; p=0.04). Among women, demographic, behavioral, and HIV-related factors were associated with incident STIs. Among men, there were no differences in incident STIs. In this first analysis comparing STI incidence between HIV-infected and HIV-uninfected adolescents, bacterial STI incidence among women significantly differed by HIV status, and factors associated with incident STIs varied by STI and HIV status.

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The three-year positivity rate of sexually transmitted infections among a group of HIV-infected men attending the Department of Genitourinary Medicine, Edinburgh, UK

Cited by 5 publications

References 0 publications

Retrospective study of the effect of enhanced systematic sexually transmitted infection screening, facilitated by the use of electronic patient records, in an HIV‐infected cohort

Retrospective study of the effect of enhanced systematic sexually transmitted infection screening, facilitated by the use of electronic patient records, in an HIV‐infected cohort

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

Incidence of sexually transmitted infections in HIV-infected and HIV-uninfected adolescents in the USA

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