Sexually Transmitted Infections in HIV Infected Patients Attending an Urban STD Clinic

Background:  To evaluate the rates and types of Sexually transmitted Infections (STIs) in HIV infected (HIV+) patients who attended a public STD clinic in Miami, Florida.

Methods:  Retrospective chart review of HIV infected individuals attending the Miami Dade County Health Department STD clinic from March to May 2012. Controls were a sample matched by age, of HIV uninfected  (HIV-) patients attending the clinic during the same period. Demographic and clinical information was abstracted and transferred to an electronic database. Data was analyzed using descriptive statistics.  The study was approved by the Institutional Review Board.

Results:  One hundred and seventy five charts were reviewed (89 HIV+ and 86 HIV-). Among the patients with HIV infection, 47 (53%) were in HIV care and 17 (19%) were diagnosed with HIV infection at the time of the study visit. There were more men in the HIV+ group than in the HIV-  group (92% versus 57%; OR=8.8, CI=3.6-21.3). Among the males, there were more men who had sex in the HIV+ group  (67% versus 15%, OR=2.62, CI=1.31-5.2). Prior to the study visit, more HIV+ patients had a history of STD (85% vs 38%; OR=3.1, CI=1.7-5.8). At the study visit, diagnosis of infectious syphilis was more common in the HIV+ group (35% versus 14%; OR=3.46, CI=1.63-7.3). There were no differences in the rates of chlamydia and gonorrhea.

Conclusions:  HIV infected individuals who attended this urban STD clinic were more likely than HIV non-infected controls to have a prior history of STIs and to have an episode of infectious syphilis. A significant number of HIV infected patients attending this clinic are not under HIV care. STI prevention strategies should be emphasized in the HIV+ population.