Background: Sexually transmitted infections (STIs) significantly increase HIV transmission. Sexually transmitted infections may be asymptomatic and therefore remain undiagnosed in HIV-positive persons. Routine screening and treatment of STIs in HIV-positive high-risk populations in sub-Saharan Africa have not been described previously. Methods: We reviewed data from an HIVpositive high-risk population at the Infectious Diseases Institute, Makerere University, a large urban HIV clinic, between July 2011 and April 2012. Our high-risk population cohort included female sex workers, long-distance drivers, barmaids, taxi drivers, commercial motorcycle ''boda-boda'' riders, soldiers, police officers, prison officers, security guards, prisoners, and fishermen. Results: Of 355 participants enrolled in the high-risk population's program, 21.4% were diagnosed with an STI either clinically or microbiologically. The STIs diagnosed in this population were syphilis, hepatitis B, genital herpes, human papilloma virus infection (condylomata acuminata), nongonococcal urethritis (NGU), and gonorrhea. Rates of syphilis, hepatitis B, genital herpes, condylomata acuminata, NGU, and gonorrhea were 8.5%, 7.0%, 5.4%, 1.4%, 1.4%, and 0.3%, respectively. Conclusion: Clinical and microbiologically diagnosed STIs were diagnosed in nearly one-fourth of the HIV-positive high-risk population. HIV care programs should note our high rates of STIs among HIV-positive high-risk populations and consider routine screening and treatment algorithms for these populations in their own settings.

Purpose of the study: Patients with HBV/HIV co-infection are at an increased risk of progression to hepatic cirrhosis and eventual liver-related death. There is limited data on HBV/HIV co-infection prevalence in adolescents and young adults in developing countries. The objective of the study was to estimate the prevalence of hepatitis B virus co-infection among HIV-positive adolescents and young adults attending an urban clinic in Kampala, Uganda. Methods: Prospective study in HIV-infected adolescents and young adults aged from 15–24 years. Summary of results: From the adolescent/young adult HIV clinic, we purposively selected a sample of 148 adolescents and young adults who had been diagnosed with sexually transmitted infections between April 2011 and March 2012. A total of 148 HIV-positive adolescents and young adults, 10 males and 138 females, aged between 15 and 24 years, were examined. Nine participants (6.1%) were HBsAg-positive and were diagnosed with hepatitis B. Hepatitis B was predominant amongst the female participants compared to the male participants: 6.1% vs 0%. The median age of the participants diagnosed with hepatitis B was 22 years (IQR: 18.5–24.0). Of the 9 HBV/HIV co-infected participants, 7 (77.8%) had CD4+counts of>250 cells/µl while 2 (22.2%) had CD4+counts<250 cells/µl (p<0.001). The median CD4+counts for the HBV/HIV co-infected participants whose CD4+counts>250 cells/µl was 434 cells/µl (IQR: 289–577). On the other hand, the participants whose CD4+counts<250 cells/µl had a median CD4+count of 120 cells/µl. There was very strong evidence to show that the 8 (88.9%) HBV/HIV co-infected participants who were in WHO stage I and II were more as compared to 1 (11.1%) HBV/HIV co-infected patients who was in WHO stage III and IV (p<0.001). Conclusion: Only 6.1% of the HIV-positive adolescents/young adults had hepatitis B co-infection. HIV/HBV co-infection was predominant among female adolescents/young adults and there was very strong evidence to show that HIV/HBV co-infection was largely associated with WHO stage I and II disease

Background. There is limited literature on the transition of young people living with HIV/AIDS (YPLHIV) from adolescent/young adult HIV care to adult HIV care in sub-Saharan Africa. Objective. We aimed to share the experiences of HIV-seropositive young adults transitioning into adult care, to inform best practice for such transitioning. Methods. We conducted a retrospective evaluation of the transition of 30 young adults aged ≥25 years from our adolescent/young adult HIV clinic at the Infectious Diseases Institute, Makerere University, Kampala, Uganda, to adult HIV healthcare services between January 2010 and January 2012. Results. Six major themes emerged from the evaluation: (i) adjustment to adult healthcare providers, (ii) the adult clinic logistics, (iii) positive attributes of the adult clinic, (iv) transfer to other health centres, (v) perceived sense of stigma, and (vi) patient-proposed recommendations. A model for transitioning YPLHIV to adult care was proposed. Conclusion. Th ere is a paucity of evidence to inform best practice for transitioning YPLHIV to adult care in resource-limited settings. Ensuring continuity in HIV care and treatment beyond young adult HIV programmes is essential, with provision of enhanced support beyond the transition clinic and youth-friendly approaches by adult-oriented care providers. S Afr J HIV Med 2013;14(1):20-23. DOI:10.7196/SAJHIVMED.885