© 1998 Oxford University Press
research-article |
Demographic, clinical and social factors associated with human immunodeficiency virus infection and other sexually transmitted diseases in a cohort of women from the United Kingdom and Ireland
aDepartment of Thoracic Medicine, Royal Free Hospital Pond St. London NW3 2QG, UK
bDepartment of Primary Care and Population Sciences, School of Rowland Hill St. Royal Free Hospital Pond St. London NW3 2PF, UK
cAcademic Department of Genito-Urinary Medlcine, Mortimer Market Centre Mortimer Market, off Capper St. London WC1E 6UA, UK
Reprint reqests: Dr S Madge, 11th floor, Department of Thoracic Medicine, Royal Free Hospital, Pond St. London NW3 2QG, UK
BACKGROUND: Clinical experience suggests many women with HIV infection have experienced no other sexually transmitted diseases (STD). Our objective was to test the hypothesis that a substantial proportion of women with HIV infection in the United Kingdom and Ereland have experienced no other diagnosed STD and to describe the demographic, clinical and social factors associated with the occurrence of other STD in a cohort of HIV infected women.
METHODS: Analysis of aoss-sectional baseline data from a prospective study of 505 women with diagnosed fly infection. The setting was 15 HIV treatment centres in the United Kingdom and ireland. The main outcome measures were occurrence of other STD diagnosed for the first time before and after HIV diagnosis. Data were obtained from interview with women and clinic notes. We particularly focused on occurrence of gonorrhoea, chlamydia and trichomoniasis after HIV diagnosis, as these are the STD most likely to reflect recent unprotected sexual intercourse.
RESULTS: The women were mainly infected via heterosexual sex (n = 304), and injection drug use (n = 174). 151 were black Africans. A total of 250(49.5%) women reported never having been diagnosed with an STD apart from HIV 255(50.5%) women had ever experienced an STD besides HIV, including 109(21.6%) who had their first other STD diagnosed after HIV. Twenty-five (5%) women reported having had chiamydia, gonorrhoea or trichomoniasis diagnosed for the first time after HIV diagnosis, possibly reflecting unprotected sexual intercourse since HIV diagnosis. In all 301(60%) women reported having had sex with a man in the 6 months prior to entry to the study. Of these, 168(58%) reported using condoms ‘always’, 66(23%) ‘sometimes’ and 56(19%) ‘never’.
CONCLUSIONS: Half the women in this study reported having never experienced any other diagnosed STD besides HIV. However, after HIV diagnosis most women remain sexuafly active and at least 5% had an STD diagnosed which reflect unprotected sexual intercourse.
Keywords HIV, women, STD
Accepted 24 February 1998