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Factors Associated With Newly Diagnosed HIV Among Persons With Concomitant Sexually Transmitted Diseases

Huhn, Gregory D. MD, MPH&TM*†; McIntyre, Anne F. PhD†‡; Broad, Jennifer M. MPH§; Holmes, Steve W. BS; Studzinski, Alice BS; Rabins, Charlie MPH; Dworkin, Mark S. MD, MPH&TM†‡

Sexually Transmitted Diseases: August 2008 - Volume 35 - Issue 8 - p 731-737
doi: 10.1097/OLQ.0b013e31817f97a0

Objective: We evaluated Illinois and Chicago Departments of Public Health surveillance databases to determine risk factors associated with newly diagnosed HIV among persons with bacterial sexually transmitted diseases (STDs).

Methods: Test results for Chlamydia, gonorrhea, early syphilis (primary, secondary, and early latent), and HIV from public health clinics in Illinois in 2002 were merged with demographic and behavioral survey data collected during patient visits. STD was defined as any positive non-HIV result.

Results: Among 43,517 patient encounters, 5814 (13.4%) had positive STD test results. There were 308 (0.7%) positive new HIV test results, of which 71 (23.1%) had concomitant infection with an STD. Compared with STD-positive, HIV-negative cases, age >30 years (OR = 1.9, 95% CI, 1.0,4.4), men who have sex with men (MSM) (OR = 22.2, 95% CI 11.3-43.7), and bisexual male (OR = 22.4, 95% CI 7.8-64.8) were independently associated with STD and HIV coinfections. Among distinct STDs, syphilis (n = 438) was the least frequent (7.5%), but was reported in the highest proportion (10.1%) of all new HIV infections and conferred the greatest risk (OR = 11.0, 95% CI 7.7-15.8) for newly diagnosed HIV.

Conclusions: MSM were at increased risk for newly diagnosed HIV with STD coinfection. Persons with a concomitant STD and HIV were older than US populations that generally constitute the greatest proportion of STD cases. These results highlight the role in particular of syphilis among populations at high risk for HIV transmission. Public health interventions targeting MSM and older adults for effective testing and prevention strategies are critically needed within high-risk networks for cotransmission of STDs and HIV.

Surveillance data from public health clinics in Illinois showed men who have sex with men and adults older than 30 years are at highest risk for newly diagnosed HIV with a concomitant sexually transmitted infection.

From the *Ruth M. Rothstein CORE Center, Cook County Bureau of Health, Rush University Medical Center, Chicago, Illinois; †Division of Infectious Diseases, Illinois Department of Public Health, Chicago, Illinois; ‡Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, Illinois; §Chicago Department of Public Health, STD/HIV Prevention and Care Program, Chicago, Illinois; and ¶Division of Infectious Diseases, Illinois Department of Public Health, STD Section, Springfield, Illinois

Supported by Illinois Department of Public Health.

Presented, in part, at 14th Conference on Retroviruses and Opportunistic Infections, abstract 867, Los Angeles, CA, February 28, 2007.

Correspondence: Gregory Huhn, MD, MPHTM, Ruth M. Rothstein CORE Center, 2020 W. Harrison St., Chicago, IL 60612. E-mail:

Received for publication October 31, 2007, and accepted February 29, 2008.

© Copyright 2008 American Sexually Transmitted Diseases Association