Background:
Fenway Community Health (FCH) is the largest provider of care for MSM in New England with 27,642 MSM visits from 2002 through 2004. Overall, 1,000 HIV-infected and more than 10,000 HIV-uninfected MSM receive primary care at FCH.

Objective:
To evaluate the prevalence of specific STDs among men screened for an STD at FCH, comparing HIV-infected with HIV-uninfected men.

Method:
The FCH electronic database was reviewed for HIV status and STD test results for all male visits 2002-2004. Data were collected as part of the CDC's MSM Prevalence Monitoring Project. The percent of patients positive for specific STDs and time trends by HIV status were compared using chi-square tests of independence.

Result:
In 2002-2004, 8277 men were tested for at least one STD; 25.8% of the tests were done for HIV-infected clients. HIV-infected men were more likely to test positive for an STD than HIV-uninfected men (p<0.0001). Urethral gonorrhea was the most common diagnosis: 17.9% in HIV-infected and 12.0% in HIV-uninfected men (p<0.0001). The percent positive for rectal and pharyngeal gonorrhea, and urethral chlamydial infection, were comparable between HIV-infected and HIV-uninfected men. However, 10.3% of the HIV-infected and 2.5% of the HIV-uninfected men had a reactive syphilis serologic test (p<0.0001). HIV-infected men were more likely to be asymptomatic than HIV-uninfected men at the time of their diagnosis (p<0.001)

Conclusion:
STDs were frequently detected among HIV-infected and HIV-uninfected men; Urethral gonorrhea and syphilis seroreactivity were most commonly diagnosed. HIV-infected men more often had an asymptomatic STD, and the overall STD burden was greater in HIV-infected than in HIV-uninfected men.

Implications:
The ongoing bacterial STD epidemic among New England MSM necessitates new and innovative prevention interventions in order to decrease STD morbidity and avoid further HIV transmission.