Background:Clinico-epidemiological profile of the Human immunodeficiency virus (HIV) epidemic in India is varied and depends on multitude of factors including geographic location. We analyzed the characteristics of HIV-infected patients attending our Immunodeficiency Clinic to determine any changes in their profile over five years.Settings and Design:A retrospective observational study.Materials and Methods:The study sample included all patients with HIV infection from January 1, 2003 to December 31, 2007. Diagnosis of HIV was made according to National AIDS Control Organization guidelines.Results:Of 3 067 HIV-infected patients, 1 887 (61.5%) were male and 1 180 (38.5%) were female patients. Mean age of patients was 35.1 ± 9.0 years. Majority (91.8%) of patients were in the age group of 15 to 49 years. Progressively increasing proportion of female patients was noted from year 2004 onward. Median CD4 count at presentation in year 2003 was 197/μl (Interquartile range [IQR] = 82.5-373) while in year 2007 it was 186.5/μl (IQR = 86.3-336.8). Mean CD4 count of male patients was 203.7 ± 169.4/μl, significantly lower as compared with female patients, which was 284.8 ± 223.3/μl (P value ≤0.05). Every year, substantial proportions of patients presenting to clinic had CD4 count<200/μl indicating advanced disease. Predominant route of transmission was heterosexual in 2 507 (81.7%) patients. Tuberculosis and oropharyngeal candidiasis were the most common opportunistic infections (OIs). Cryptococcal meningitis was the most common central nervous infection. Our patients had comparatively lower median CD4 counts at the time of presentation with various OIs.Conclusions:Patients had advanced stage of HIV infection at the time of presentation throughout five years. Females presented earlier during the course of HIV infection. There is need for early screening and increasing awareness in healthcare providers to make a diagnosis of HIV much sooner.

Introduction: Sex addiction is the inability to control sexual impulses resulting in continued sex related behaviors despite the negative consequences . This is the first study conducted on PSA among MSM in Sri Lanka .Objective: To describe the prevalence of PSA and its associating factors among MSM who attend STD clinic, Kalubowila . Method:A descriptive cross sectional study was conducted among 240 MSM clinic attendees for a period of 1 year, using the PATHOS screening tool via an interviewer administered questionnaire . PATHOS consists of six items found in both the Sexual Addiction Screening Test (SAST) and its revision, and the cut off value is 3 . Data was analyzed by SPSS . Result:The mean age of participants was 29 .38 years (SD 9 .7) . Majority were unmarried, had male partners only and had 1 or more partners in last 3 months . A quarter was diagnosed with a new STD and among them, 3 were diagnosed with HIV . Eighty-two MSM had PATHOS cut off value, giving 34% prevalence of PSA . Approximately 75% felt that their life was controlled by sexual desire, and 40% felt depressed following sex . Presence of PSA was not significantly associated with the presence of a STD(p=0 .224623), sex of partners(p=0 .289935) or number of partners . However, PSA was significantly associated with behaviours such as insertive and receptive anal sex (p=0 .041046 & p=0 .037916) and feeling depressed following a sexual act (p <0 .00001) . Conclusion:PSA is high among MSM who attended this STD clinic which needs further psychosexual assessment .

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