PROVIDENCE, R.I. [Brown University] To maximize HIV prevention efforts in South Africa and perhaps the broader region, public health officials should consider testing for other sexually transmitted infections when they test for HIV, according to a new paper in the journal Sexually Transmitted Infections.
STIs can make HIV easier to transmit even after antiretroviral therapy has begun, so rooting out STI co-infections in patients should improve HIV prevention. The new study led by Brown University public health researchers emphasizes that sooner is indeed better than later, because the data show that HIV-positive South Africans were much more likely to be troubled by STIs before starting HIV treatment than after.
Originally in the study, which was a review of medical records of more than 1,400 HIV-positive Cape Town city clinic patients, the researchers were looking to see whether people already on antiretroviral therapy were subsequently contracting STIs that could undermine the HIV-prevention benefits of their treatment. But when they looked at the patients' histories, they found that the time when most people contracted STIs was well prior to starting the drugs.
"Once people get on antiretroviral treatment, STI's become less prevalent," said Mark Lurie, assistant professor of epidemiology at Brown University and lead author, whose research team included graduate student Kirwa Kipruto. "It's really the period prior to that that's especially important."
Specifically, among the 1,465 HIV-positive patients who agreed to take part in the study, 131 people sought STI treatment in a total of 232 incidences (some people sought care multiple times). More than 87 percent, or 203, of the incidences occurred before the patients received antiretroviral treatment, or ART. Controlling for other potential confounders, the researchers found that people on ART were seven times more likely to seek treatment for a sexually transmit
|Contact: David Orenstein|