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High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection.
Clin Infect Dis. 2018 02 10; 66(5):735-742.CI

Abstract

Background

Knowledge of the risk factors of individuals with an asymptomatic sexually transmitted infection (STI) is essential for implementation of targeted STI screening strategies.

Methods

Between June 2015 and January 2017, an STI screening was offered to all participants in the Zurich Primary human immunodeficiency virus (HIV)-1 Infection study. Patients were tested for gonorrhea, chlamydia, syphilis, and hepatitis C virus (HCV).

Results

Of 214 participants, 174 (81%) were screened at least once. Most patients were men who have sex with men (MSM) (87.4%). Presenting with a primary HIV infection was associated with higher odds for later risky sexual behavior, as compared with presenting in the chronic phase (odds ratio [OR], 5.58; 95% confidence interval [CI], 3.68-8.8). In total, 79 STIs were detected, reflecting a high period prevalence of 33.3% (58 of 174 patients). Sixty-six percent of patients (52 of 79) were asymptomatic. Most common STIs were chlamydia (50.6%; 40 of 79 patients), gonorrhea (25.3%; 20 of 79), and syphilis (19%; 15 of 79). In a multivariable model, engaging in insertive (OR, 6.48; 95% CI, 1.14-36.76) or both insertive and receptive (4.61; 1.01-20.96) anal intercourse, STI symptoms (3.4; 1.68-6.89), and condomless sex (2.06; 1.14-3.74) were positively correlated with a positive screening result. The hazard of an incident STI increased with the presence of STI symptoms (hazard ratio, 3.03; 95% CI, 1.17-7.84) and any recent drug use (2.63; 1-6.9).

Conclusions

A trimonthly STI screening including asymptomatic individuals should be considered in this population, particularly in MSM who report sexual risk behavior.

Clinical Trial Registration

NCT 00537966.

Authors+Show Affiliations

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich. Institute of Medical Virology, University of Zurich, Switzerland.Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich.Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich.Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich. Institute of Medical Virology, University of Zurich, Switzerland.Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich.Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich. Institute of Medical Virology, University of Zurich, Switzerland.Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich. Institute of Medical Virology, University of Zurich, Switzerland.Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich. Institute of Medical Virology, University of Zurich, Switzerland.No affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29028966

Citation

Braun, Dominique L., et al. "High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 66, no. 5, 2018, pp. 735-742.
Braun DL, Marzel A, Steffens D, et al. High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection. Clin Infect Dis. 2018;66(5):735-742.
Braun, D. L., Marzel, A., Steffens, D., Schreiber, P. W., Grube, C., Scherrer, A. U., Kouyos, R. D., & Günthard, H. F. (2018). High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 66(5), 735-742. https://doi.org/10.1093/cid/cix873
Braun DL, et al. High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection. Clin Infect Dis. 2018 02 10;66(5):735-742. PubMed PMID: 29028966.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection. AU - Braun,Dominique L, AU - Marzel,Alex, AU - Steffens,Daniela, AU - Schreiber,Peter W, AU - Grube,Christina, AU - Scherrer,Alexandra U, AU - Kouyos,Roger D, AU - Günthard,Huldrych F, AU - ,, PY - 2017/07/03/received PY - 2017/10/03/accepted PY - 2017/10/14/pubmed PY - 2019/10/23/medline PY - 2017/10/14/entrez SP - 735 EP - 742 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 66 IS - 5 N2 - Background: Knowledge of the risk factors of individuals with an asymptomatic sexually transmitted infection (STI) is essential for implementation of targeted STI screening strategies. Methods: Between June 2015 and January 2017, an STI screening was offered to all participants in the Zurich Primary human immunodeficiency virus (HIV)-1 Infection study. Patients were tested for gonorrhea, chlamydia, syphilis, and hepatitis C virus (HCV). Results: Of 214 participants, 174 (81%) were screened at least once. Most patients were men who have sex with men (MSM) (87.4%). Presenting with a primary HIV infection was associated with higher odds for later risky sexual behavior, as compared with presenting in the chronic phase (odds ratio [OR], 5.58; 95% confidence interval [CI], 3.68-8.8). In total, 79 STIs were detected, reflecting a high period prevalence of 33.3% (58 of 174 patients). Sixty-six percent of patients (52 of 79) were asymptomatic. Most common STIs were chlamydia (50.6%; 40 of 79 patients), gonorrhea (25.3%; 20 of 79), and syphilis (19%; 15 of 79). In a multivariable model, engaging in insertive (OR, 6.48; 95% CI, 1.14-36.76) or both insertive and receptive (4.61; 1.01-20.96) anal intercourse, STI symptoms (3.4; 1.68-6.89), and condomless sex (2.06; 1.14-3.74) were positively correlated with a positive screening result. The hazard of an incident STI increased with the presence of STI symptoms (hazard ratio, 3.03; 95% CI, 1.17-7.84) and any recent drug use (2.63; 1-6.9). Conclusions: A trimonthly STI screening including asymptomatic individuals should be considered in this population, particularly in MSM who report sexual risk behavior. Clinical Trial Registration: NCT 00537966. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/29028966/High_Rates_of_Subsequent_Asymptomatic_Sexually_Transmitted_Infections_and_Risky_Sexual_Behavior_in_Patients_Initially_Presenting_With_Primary_Human_Immunodeficiency_Virus_1_Infection_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cix873 DB - PRIME DP - Unbound Medicine ER -