Effect of Highly Active Antiretroviral Therapy on Diagnoses of Sexually Transmitted Diseases in People with AIDS [Scheer S, et al. Lancet 2001;357:432]: This is a report from the Department of Public Health in San Francisco which made a computerized match of San Francisco residents in the STD and AIDS registries. Analysis of data showed that AIDS patients receiving HAART had a 4.1-fold increase in STDs compared to AIDS patients not receiving HAART. The number of STD cases among AIDS patients increased from 60 in 1995 to 113 in 1998. The authors concluded that HAART is an "epidemiologic marker of unsafe sex."
Comment: Previous studies have shown that the frequency of unsafe sex increases with HAART [AIDS 1999;13:1525; MMWR 1999;48:45]. The results of Sheer's study underscore the importance of prevention efforts for persons with HIV, especially for those who are young and who have a relatively good health status. These observations also suggest that the benefit achieved by reducing transmission through decreased viral loads may be offset by increases in high-risk behavior.
posted 3/1/2001

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