Co Morbid Infections Among the HIV+ MSM Client Population within the Baltimore City Health Department

Background: The Baltimore City Health Department has experienced a significant increase in the numbers of HIV positive MSM (Men Who Have Sex with Men) who return to the clinics diagnosed with new sexually transmitted infections.  The number of BCHD clinic visits by this population has steadily increased since 2008. 

Objectives: To describe an increasing trend in the number of HIV+ MSM clients within the Baltimore City Health Department who present with subsequent bacterial infections.

Methods: The numbers of BCHD HIV+ clinic visits were extracted from the Insight database.  Visits by men who self disclosed their HIV status or who tested positive for HIV were identified, along with their diagnoses.  The clinic visits were non-unique; therefore multiple clinic visits made by the same patient were included in the totals.

Results: The 101 clinic visits by HIV+ MSM patients in 2008 increased to a total of 327 for the 1^st quarter of 2011. Positive Chlamydia tests, in this population increased from 6.9% to 12% from 2008 to 2010. The percentage of gonorrhea diagnosis increased from 6.9% to 18.1%, with 7 cases diagnosed in 2008 to 36 total cases diagnosed in 2010.  The number of syphilis cases among MSM increased from 31 in 2008 to 61 in 2010. 

Conclusions:  The HIV+ MSM experienced marked increases in subsequent bacterial infections since 2008.

Implications for Programs, Policy, and Research: Programs need to be developed that affect this population’s escalating STD rate, decrease behaviors that place MSM at risk, and increase barrier method use.