Sexually transmitted disease acquisition among HIV-infected women

S. J. Bersoff-Matcha, M. M. Horgan, B. P. Signer, L. M. Mundy, V. J. Fraser

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Abstract

Objective: Little data are available on the relationship between HIV infection and other STDs in women. We report on incident and prevalent STDs among HIV infected women followed in a university-based longitudinal care clinic. Methods: All women enrolled in an urban HIV clinic were evaluated at enrollment and follow-up for gonorrhea (GC), chlamydia (Ct), trichomonas (trich), genital herpes (HSV), genital warts, pelvic inflammatory disease (PID), and syphilis. Results: One hundred thirty-seven HIV-infected women (ages 20 and older) were enrolled and followed for a mean of 19.3 months. At enrollment, mean CD4 count was 390/mm3 (range 1-1288/mm3); twenty of 119 evaluable patients were pregnant (16.8%) and 25 of 117 patients (21.4 %) had at least one STD. Distribution of specific STDs was as follows: One GC (1%), 2 Ct (2%), 12 trich (10%), 6 HSV (5%), and 8 syphilis (6%). An abnormal Pap smear was seen in 100 women (81%); 38 women (31%) had CIN-I or greater. Incident STDs were found in 38 of the 118 patients (32%) who returned for at least one follow-up visit. Distribution of these incident STDs was as follows: 4 GC (3%), 4 Ct (3%), 17 trich (15%), 17 HSV (15%), 4 warts (3%), 3 PID (3%) 5 syphilis (5%). Fifty-three (47%) used long-acting hormonal contraceptives, and none used condoms consistently. Ten patients (8%) became pregnant during follow-up. Conclusions: High rates of STDs among HIV-infected women indicate high-risk sexual behavior, despite intensive counseling at enrollment and follow-up. Risk-reduction messages must stress both consistent condom use and hormonal contraception. Aggressive cervical screening is necessary given the high rate of CIN seen in this population of women.

Original languageEnglish
Number of pages1
JournalClinical Infectious Diseases
Volume25
Issue number2
StatePublished - Dec 1 1997

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