Risk for HIV following a diagnosis of syphilis, gonorrhoea or chlamydia: 328,456 women in Florida, 2000–2011

Abstract

Several effective interventions are available for preventing HIV in women. Targeting interventions requires understanding their risk of acquiring HIV. We used surveillance data to estimate risks of HIV acquisition for 13-59-year-old women following a diagnosis of syphilis, gonorrhoea or chlamydia in Florida during 2000-2009. We excluded women reported with HIV before their STI, and measured HIV reported subsequent to STI (through 2011). Rates were compared to women with no reported STI. A total of 328,456 women had: syphilis (3325), gonorrhoea (67,784) or chlamydia (257,347). During 2,221,944 person-years of follow-up, 2118 of them were diagnosed with HIV. For women with no STI reported, during 64,763,832 person-years, 19,531 were reported with HIV. The crude rate of subsequent HIV diagnosis (per 100,000 person-years) was higher for women diagnosed with syphilis (597.9), gonorrhoea (171.3) or chlamydia (66.3) than women with no STI (30.2). Annual rates of HIV decreased over-all by 61.8% between 2001 and 2011. Women with syphilis or gonorrhoea were at highest risk for HIV and therefore might benefit from intensive counselling. However, they represented only a small fraction of the women who acquired HIV. Most cases of HIV infection among women occurred among the large group of women who were not at highest risk.

Hyperendemic Chlamydia trachomatis sexually transmitted infections among females represent a high burden of asymptomatic disease and health disparity among Pacific Islanders in Fiji

“…The poor sensitivity and specificity of this approach has likely led to the under treatment of C. trachomatis STIs and a large reservoir of individuals in Fiji who can not only transmit C. trachomatis to their sexual partners but develop upper genital tract sequelae, including infertility. Further, C. trachomatis is a risk factor for HIV acquisition [14]. While HIV prevalence remains at approximately 0.1% in the PICT [36,37], except for Papua New Guinea, the epidemic proportions of C. trachomatis with an economy built on tourism leaves Fiji and other PICT extremely vulnerable to the rapid spread of HIV and its consequent morbidity and mortality.…”

“…This is complicated by the fact that the WHO recommends syndromic management, which relies primarily on signs and symptoms, in low-income and low-resource settings [12]. Undiagnosed and therefore untreated C. trachomatis can lead to pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain, infertility and adverse pregnancy outcomes in addition to an increased risk of cervical cancer and HIV [9,13,14,15].…”

In vitro activities of a new fluoroquinolone derivative highly active against Chlamydia trachomatis

“…Chlamydia trachomatis (C. trachomatis), an obligate intracellular Gram-negative bacterium, is responsible for the most common sexually transmitted bacterial infection in the world (131 million new cases in 2012, WHO data), 1 which causes severe complications leading to serious sequelae in men and women, including infertility. This infection also facilitates other sexually transmitted infections (STI), including HIV, 2,3 and increases the incidence and persistence of human papillomavirus (HPV) infection. 4,5 C. trachomatis is also responsible for trachoma, the most common infectious cause of blindness.…”

Offering pre-exposure prophylaxis for HIV prevention to pregnant and postpartum women: a clinical approach

“…Even with the same number of sexual partners and encounters, African-American women are at higher risk of HIV acquisition [ 54 , 55 ]. Additional factors associated with HIV diagnoses in US women include recent gonorrhoea or syphilis [ 56 ], IPV [ 57 ], exchange sex and drug use [ 58 ], among others. However, many US women diagnosed with HIV had no identifiable risk factor other than heterosexual sex [ 56 ].…”