Wednesday, March 30, 2016

Risk Factors Associated with Incident Sexually Transmitted Infections in HIV-Positive Patients in the Australian HIV Observational Database

We established a subcohort of HIV-positive individuals from 10 sexual health clinics within the Australian HIV Observational Database (AHOD). The aim of this study was to assess demographic and other factors that might be associated with an incident sexually transmitted infection (STI).

The cohort follow-up was from March 2010 to March 2013, and included patients screened at least once for an STI. We used survival methods to determine time to first new and confirmed incident STI infection (chlamydia, gonorrhoea, syphilis or genital warts). Factors evaluated included sex, age, mode of HIV exposure, year of AHOD enrolment, hepatitis B or C coinfection, time-updated CD4 cell count, time-updated HIV RNA viral load, and prior STI diagnosis.

There were 110 first incident STI diagnoses observed over 1015 person-years of follow-up, a crude rate of 10.8 per 100 person-years. Factors independently associated with increased risk of incident STI included younger age [≥ 50 vs. 30-39 years old]; prior STI infection, and heterosexual vs. men who have sex with men (MSM) as the likely route of exposure.

In this cohort of individuals being treated with antiretroviral drugs, those who were MSM, who were 30-39 years old, and who had a prior history of STI, were at highest risk of a further STI diagnosis.

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  • 1The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
  • 2University of Sydney, Camperdown, NSW, Australia.
  • 3Holden Street Sexual Health Clinic, Gosford, NSW, Australia.
  • 4Illawarra Sexual Health Services, Warrawong, NSW, Australia.
  • 5University of Wollongong, Wollongong, NSW, Australia.
  • 6Caradata, Arundel DC, Qld, Australia.
  • 7Tamworth Sexual Health, Clinic 468, HNEAHS, NSW, Australia.
  • 8Nepean/Blue Mountains Sexual Health, Nepean Hospital, Kingswood, NSW, Australia.
  • 9Sydney Sexual Health Centre, Sydney, NSW, Australia.
  • 10Melbourne Sexual Health Centre, Alfred Hospital, Prahran, Vic., Australia.
  • 11Cairns Sexual Health Service, Cairns, Qld, Australia.
  • 12Central Clinical School Monash University, Alfred Hospital, Melbourne, Vic., NSW, Australia.
  • 13Lismore Sexual Health Services, Lismore, NSW, Australia.
  • 14RPA Sexual Health, Camperdown, NSW, Australia. 
  •  2016 Mar 28. doi: 10.1111/hiv.12371

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