Trends in Reported Syphilis and Gonorrhea among HIV-Infected People in Arizona: Implications for Prevention and Control

Abstract

Objective. HIV and sexually transmitted disease (STD) surveillance patterns in Arizona suggested the need for integrated data analyses to identify trends. Methods. We compiled all HIV/AIDS cases diagnosed from 1998 to 2008 that were reported in Arizona and syphilis or gonorrhea cases diagnosed from 1998 to 2008 in Arizona. We used deterministic matching to identify individuals who were diagnosed with HIV and one or more STDs, and calculated time intervals between diagnoses. Results. Of 23,940 people with HIV/AIDS reported from 1998 to 2008, 1,899 (2.6%) had at least one syphilis or gonorrhea diagnosis from 1998 to 2008. Approximately 85% of these cases reported male-to-male sexual contact. Among males with syphilis, HIV coinfection increased from 0.5% in 1998 to 29.1% in 2008. Among males with gonorrhea, HIV coinfection increased from 2.0% in 1998 to 3.1% in 2008. Among HIV cases diagnosed from 2004 to 2008 and reported with at least one syphilis or gonorrhea diagnosis, the majority of syphilis cases (76.1%) were diagnosed at or after HIV diagnosis, whereas a majority of gonorrhea cases (54.9%) were diagnosed prior to HIV diagnosis. Conclusion. Use of the deterministic matching method identified increases in STD infections among HIV-infected people. The routine performance of this cross-matching method may be a useful tool in identifying these high-risk individuals so that targeted partner services and appropriate care referrals may be used in a timely fashion.

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

“…High positivity among asymptomatic MSM screened for rectal GC and CT has been reported in multiple US jurisdictions , demonstrating a risk for HIV acquisition. Increasing rates of sexually transmitted diseases (STDs) diagnosed among HIV‐infected persons have been reported from multiple US jurisdictions and suggest ongoing risk behaviour for HIV transmission .…”

Reported Primary and Secondary Syphilis Cases in the United States: Implications for HIV Infection

“…6–8 In addition, the populations disproportionately affected by HIV, including MSM and certain race/ethnicity groups, are similar to the populations at increased risk for syphilitic infection, 9 and multiple reports have documented a high prevalence of HIV coinfection among men and MSM with P&S syphilis. 4,10,11 Primary and secondary syphilis might be an indication of condomless sexual contact within sexual networks at high risk for HIV transmission. Therefore, a diagnosis of P&S syphilis might also represent an opportunity for public health and clinical intervention to (1) prevent HIV infection among those who are HIV negative and (2) identify and link to care those who are living with HIV infection but not currently engaged in care.…”

Syphilis among adolescents and young adults in Cincinnati, Ohio: testing, infection and characteristics of youth with syphilis infection

“…7–9 Infection occurred in women and men at similar rates and few men with syphilis infection reported a same sex partner. These findings suggest:(i) syphilis screening should include considerations of local epidemiological data; (ii) assessing all risk factors is an important component in deciding who warrants syphilis testing; and (iii) heterosexual and HIV-uninfected men should be screened for syphilis based on risk factors (e.g.…”