STD Co-infection among Acute HIV Patients in Los Angeles County

Background:
Sexually transmitted diseases (STDs) in HIV-positive individuals increases the risk of HIV transmission. Detecting acute HIV infection and treating STDs in the earliest stage of an HIV infection will prevent further HIV transmission.

Objective:
To examine the prevalence of STDs among a cohort of acutely infected HIV patients in Los Angeles County (LAC).

Method:
Acute HIV cases were identified through pooled testing using Roche Amplicor® Monitor HIV-1 or the GenProbe Aptima assays of HIV Ab negative (Vironostika® HIV1) persons in 14 STD clinics and an incarcerated MSM population in LAC. Test results for gonorrhea (GC), syphilis and chlamydia (CT) were obtained from medical charts and STD surveillance data.

Result:
From February 2006 through October 2007, 34 persons with acute HIV were identified; 32 were tested for at least one other STD. Of these, 29 were MSM; two were MSW; and one was a M-to-F transgender who had sex with men. All 32 acute HIV cases were tested for CT and GC; 30 patients were additionally tested for syphilis. Overall, 18 (56.3%) acute HIV patients were co-infected with at least one other STD: 7 (21.9%) had CT, 14 (43.8%) had GC and 6 (20%) had syphilis. Of these, 2 had CT only; 7 GC only; 2 syphilis only; 3 CT/GC; 2 syphilis/GC; and 2 with syphilis/CT/GC.

Conclusion:
STD co-infection in the acute stage of HIV infection is common. Any MSM with an STD and a negative HIV Ab test should be tested for acute HIV infection with a more sensitive test.

Implications:
Prevention efforts should include testing to detect acute HIV among persons with STDs. Individuals with acute HIV and an STD co-infection provide a target for intervention to reduce HIV transmission.