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Frequency
of STDs in HIV-infected patients who don't have sex
Use
of a Public Sexually Transmitted Disease Clinic by Known HIV-Positive
Adults: Decreased Self-Reported Risk Behavior and Increased Disease
Incidence [Brewer TH et al. JAIDS 2002;29:289]: This
is a report from four Dade County STD clinics correlating self-reported
sexual activity and the diagnosis of STDs. The retrospective study
included 191 HIV-infected patients and 191 HIV-negative controls.
The HIV-infected group was significantly more likely to report no
sexual activity in the last two months and, among those who were
sexually active, higher rates of condom use. However, these patients
were also more likely to have a diagnosis of syphilis or gonorrhea.
Results are summarized in the following table:
| |
| |
|
|
|
|
HIV
pos
n = 191
|
HIV-negative
n = 191 |
| Sex
behavior hx |
|
|
| Condom
use last act |
80
(47%) |
36
(20%) |
| Condom
use always (2 mo) |
49
(41%) |
24
(17%) |
| No
sex partners (2 mo) |
55
(30%) |
31
(16%) |
| |
|
|
| Sexually
transmitted disease |
|
|
| Gonorrhea |
25
(13%) |
13
(7%) |
| Syphilis |
12
(6%) |
1
(0.5%) |
| |
|
|
Comment: This
study is topical due to the shift in CDC policy regarding prevention
strategies that now concentrate on persons with known HIV infection
(Am J Public Health 2001;91:1015). Previous reports have shown that
persons with HIV infection often continue to practice unsafe sex
despite this diagnosis (JAMA 1992;267:843; STD 2000;27:483; JAIDS
2000;25:192) and that this trend may be increasing (Am J Pub Health
1999;89:1093). The data shown here indicate the probable over reporting
of condom use and sexual abstinence, and also emphasize the potential
utility of STD screening as a surrogate marker of high-risk behavior
as well as need for treatment.
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