Routine voluntary HIV screening in STD clinic clients: characterization of infected clients

Article Abstract:

Human immunodeficiency virus (HIV, the cause of AIDS) has been primarily spread by sexual contact, and thus patients at sexually transmitted disease (STD) clinics have a higher risk of HIV infection than the general population. HIV testing and counseling at STD clinics have been recommended by the Centers for Disease Control (CDC). The features of clients at STD clinics in Baltimore who were identified with HIV infections during 1988, the first year of HIV testing, are described. Among 20,843 clients, 15,181 agreed to testing. Four percent were HIV-positive, but a higher rate of infection was found in other surveys of those who refused testing. Seventy-one percent of HIV-positive subjects returned for results and evaluation. Those who did not return were more likely to be male and never married, while those who returned were more likely to be homosexual. Of 437 returning HIV-positive subjects, 75 percent were black men and 23 percent were black women. Most infected subjects were aged 20 to 34 years, and women tended to be younger than men. Forty-two percent of men were homosexual, 40 percent used drugs intravenously (IV), and 22 percent had sexual partners who were IV drug users. Twenty-two percent of men reported two or more HIV risk factors, while 35 percent of men under 25 years admitted no risk factors. IV drug use was reported by 39 percent of women, while 19 percent reported IV drug users as sexual partners, and 27 percent of HIV-positive women had two or more risk factors. Most patients had few or no symptoms of infection. Between 40 and 50 percent of both men and women altered their reported risk factors after identification of their HIV-positive status. Few clients had health insurance and many had poor social support systems. The results support making HIV testing available to all STD clinic clients, not only those who admit to, or are aware of, risk factors for HIV. Testing of this high-risk population is important since anti-HIV therapy with zidovudine can be instituted while patients are at an early disease stage and can gain benefit from treatment. The data also suggest that a potential burden to public health care systems exists in these subjects. Further study of these and other issues is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

HIV patients, Maryland, HIV seropositivity, HIV positive

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Condom use to prevent incident STDs: the validity of self-reported condom use

Article Abstract:

Self-reported use of condoms may not be a reliable measure of condom use among populations at high risk for sexually transmitted diseases (STDs). A group of 323 men and 275 women attending STD clinics in Baltimore were interviewed about their sexual habits and STD history. All participants were examined and treated for gonorrhea, chlamydia, syphilis, or trichomoniasis, if present and given an appointment for a follow-up visit. Three months later, the interview and examination were repeated. Among the men who reported using condoms for every act of intercourse, the incidence of new infection was 15% compared with 15.3% of men who reported never using condoms. Among women who reported using condoms for every act of intercourse, 23.5% had a new infection versus 26.8% who reported that they never used condoms. Since condoms protect against STDs, this strongly suggests inaccurate reporting.

Usage, Condoms, Interviews

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Definitions of genital ulcer disease and variation in risk for prevalent human immunodeficiency virus infection

Article Abstract:

Variations in genital ulcer disease (GUD) definitions may alter how strongly associated this disease is with risk for HIV infection. HIV infection risk was evaluated using varying GUD definitions among 863 new patients at a sexually transmitted disease clinic. Patients with a previous syphilis infection were six times more likely to be HIV-positive while those with laboratory evidence of a syphilis infection were 3.7 times more likely to be HIV-positive. Patients with current GUD characteristics were twice as likely to be HIV-positive. Overall, 5.2% of the female patients and 12.5% of the male patients were HIV-positive.

Complications and side effects, Risk factors, HIV infection, HIV infections, Genital diseases, Male, Male genital diseases, Genital diseases, Female, Female genital diseases

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