High prevalence of sexually transmitted coinfections among at-risk people living with HIV

• Main Authors: Kuan-Yin Lin, Hsin-Yun Sun, Tai-Fen Lee, Yu-Chung Chuang, Un-In Wu, Wen-Chun Liu, Sui-Yuan Chang, Yi-Jing Chen, Chien-Ching Hung, Shan-Chwen Chang
• Format: Article
• Language: English
• Published: Elsevier 2021-10-01
• Series: Journal of the Formosan Medical Association
• Subjects: Condomless anal intercourse; Men who have sex with men; Viral hepatitis; Chlamydia trachomatis; Neisseria gonorrhoeae
• Online Access: http://www.sciencedirect.com/science/article/pii/S0929664620306082

Background/Purpose: Concurrent sexually transmitted infections (STIs) are not uncommon in at-risk populations, for which control requires integrated testing, treatment and prevention. Methods: From May, 2019 to February, 2020, multiplex real-time PCR assays were prospectively performed to detect Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) in the urine and rectal/vaginal swab specimens collected from HIV-positive patients with a history of STIs or symptoms suggestive of STIs. Patients confirmed to have acquired STIs were treated according to treatment guidelines. Results: During the study period, 430 participants (99.1% men who have sex with men and median age 37 years) were included. The overall prevalence of CT, NG, and/or TV infection was 30.0%, including 24.7%, 12.1%, and 0.2% for CT, NG, and TV infection, respectively. The factors associated with CT, NG, and/or TV infection were hepatitis B surface antigen (HBsAg) seropositivity (AOR, 2.76; 95% CI, 1.22–6.26), recently acquired hepatitis C virus (HCV) infection (AOR, 5.62; 95% CI, 1.99–15.88), using mobile dating application (AOR, 2.08; 95% CI, 1.13–3.83), and oral sex (AOR, 2.12; 95% CI, 1.04–4.32). The rates of CT, NG, and/or TV infection were 50.0% in participants with recent HCV infection, 44.2% in those with HBsAg positivity, and 35.9% in those with incident syphilis. Among participants completing test-of-cure visits, the microbiological cure rate was 91.7% and 90.0% for chlamydia and gonorrhea, respectively. Conclusion: HIV-positive participants had a high prevalence of CT and/or NG, especially those coinfected with viral hepatitis and syphilis. Our results strongly support integrated STI services in the population.