High Rates of STIs in HIV-Infected Patients Attending an STI Clinic in Miami

OBJECTIVES:

To evaluate the rates and types of sexually transmitted infections (STIs) in patients infected with the human immunodeficiency virus (HIV) attending a public STI clinic in Miami, Florida as compared with HIV-uninfected patients attending the same clinic.

METHODS:

This was a retrospective review of medical records of individuals attending the Miami-Dade County Health Department STI clinic from March 2012 to May 2012. Demographic and clinical information was abstracted and transferred to an electronic database. Consecutive age-matched HIV-infected and HIV-uninfected patients were identified during the study period. Demographics, risk factors, and history and rates of STIs for HIV-infected and HIV-uninfected patients and for those with newly diagnosed and previously diagnosed HIV infection were compared.

RESULTS:

A total of 175 medical records were reviewed (89 HIV-infected patients and 86 HIV-uninfected patients). The median age was 37 years. A history of STIs, including syphilis, was more common in HIV-infected than in HIV-uninfected patients. Individuals with a prior diagnosis of HIV were more likely to be older (older than 37 years of age, χ(2) = 15.3, P < 0.01), male (χ(2) = 4.74, P = 0.05), to have a new STI (χ(2) = 5.83, P = 0.01), to have a new diagnosis of syphilis (χ(2) = 5.15, P = 0.01), and to be under medical care (χ(2) = 31.19, P < 0.001) than those newly diagnosed as having HIV.

CONCLUSIONS:

HIV-infected individuals who attended this urban STI clinic had high rates of new and past STIs, suggesting the persistence of high-risk sexual behaviors. STI clinics could be a premier site to identify individuals with HIV and high-risk sexual behaviors who could benefit from additional targeted interventions.

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By:  Castro JG1, Alcaide ML1.

• 1From the Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida. 

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The Role of Depression in Retention in Care for Persons Living with HIV

Individuals infected with HIV experience high rates of depression when compared to their sero-negative counterparts. Although symptoms of depression have been consistently linked to poor medication adherence among persons living with HIV/AIDS, their relation to retention in care are less well-known. 

The purpose of this study was to examine whether clusters of depressive symptoms influence retention in care and if so, whether these clusters had different relations to retention in care. This is a secondary data analysis of a larger study that investigated the role of health literacy, cognitive impairment, and social determinants on retention in HIV care. Individuals with HIV were recruited from South Florida from August 2009 to May 2011. A total of 210 participants were included in the current analyses. 

A measure of visit constancy was calculated to represent the number of 4-month intervals with at least one kept visit. Individual items on the Center for Epidemiological Studies Depression Scale short form (CES-D10) and factor analysis of the CES-D10 were independent variables. 

Overall, there was a high prevalence of depressive symptoms in the study participants. Furthermore, factor analysis showed that certain clusters of depressive symptoms were significantly associated with visit constancy. Specifically, negative mood/somatic symptoms were associated with a greater odds of missing a visit in any of the observed 4-month time periods than positive mood factor. 

Those patients reporting somatic symptoms and negative mood may need additional intervention and support to be effectively retained in care and successfully follow through with appointments and care.

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By: Julie Ann Zuniga, PhD, RN,¹ Moka Yoo-Jeong, RN,² Tian Dai, MS,³ Ying Guo, PhD,³ and Drenna Waldrop-Valverde, PhD²

¹School of Nursing, The University of Texas at Austin, Austin, Texas.

²Nell Hodgson School of Nursing, Emory University, Atlanta, Georgia.

³Rollins School of Public Health of Department of Biostatistics and Bioinformatics, Emory University, Atlanta,Georgia.

  

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HIV Testing Practices among Latina Women At Risk of Getting Infected: South Florida

Abstract:  Latinos are more likely to delay HIV testing, present to care with an AIDS defining illness, and die within one year of learning their HIV-positive status than non-Latino blacks and whites. For this paper, we explore the role of partner-relationship characteristics and health behaviors, in predicting HIV testing among Latina adult women who engaged in risky sexual behaviors (i.e., unprotected vaginal and/or anal sex). Data from a convenience sample of 168 Latina adult women who engaged in risky sexual behavior in the year prior to assessment were analyzed for this paper. 

Rates and predictors of HIV testing among this sample were assessed after a five-year follow-up. Descriptive and analytical estimates include incidence rates and adjusted odds ratios from multilevel models. At five-year follow-up, 63.7% women reported having been tested for HIV, of whom 12.2% were women who never tested before. Main reasons for not having been tested at follow-up included: low risk perception (62.1%) and trusting their partner(s)/being in a monogamous relationship/knowing their partner's HIV status (17.2%). 

Predictors of HIV testing included: age, provider endorsement of HIV testing, poor quality of their romantic relationships  and knowing the HIV sero-status of sexual partner. 

This study characterizes a group of Latina women at high risk for HIV infection and their HIV testing behaviors. Our findings underscore the need of increasing access to quality health-care services and HIV behavioral interventions, and to strengthen the adherence to HIV/sexually transmitted disease testing recommendations and guidelines among local health-care providers serving the Latino community in South Florida.

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