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Background: Men diagnosed with rectal gonorrhea and chlamydia are at risk for HIV acquisition and transmission.
Methods: Rectal gonorrhea (GC) and chlamydia (CT) testing data from males attending the STD Clinic during October 1, 2011-September 30, 2013 were cross-matched with HIV surveillance data to identify men with HIV co-infection. We examined HIV status, HIV diagnosis date, and the values of VL collected within one year of the rectal infection.
Results: During the two year time period, there were a total of 1,591 men that were tested for rectal GC and CT. Of men tested, 506 (31.8%) were positive for GC (13.2%), CT (12.2%) or both (6.4%). The median age of men with rectal infection (N = 506) was 25 (range 16-62); 214 (42.3%) were White, 62 (12.3%) were Black, and 80 (15.8%) were Hispanic. Of men with rectal infection, 380 (75.1%) had no reported history of HIV infection, 90 (17.8%) were diagnosed with HIV prior to rectal infection, 29 (5.7%) were diagnosed with HIV at the time of rectal diagnosis and 7 (1.4%) were diagnosed with HIV after rectal diagnosis. Of the 119 men with HIV at the time of rectal diagnosis (23.5%): 28 (23.5%) had no reported VL; 34 (28.6%) had an undetectable viral load (<200 c/ml) and 57 (47.9%) had a detectable VL collected within one year of rectal diagnosis (median 33,769 c/ml, range 239-10,000,000 c/ml), (median days from rectal diagnosis to VL collection 18, range -363-336 days).
Conclusions: Approximately one-quarter of men with rectal GC and CT also had HIV. Only 28.6% of HIV-infected men with rectal GC or CT had an undetectable viral load collected near the time of rectal diagnosis, suggesting most were at high risk for transmitting HIV.