Gonorrhoea or chlamydia in a US military HIV-positive cohort
- Alicen B Spaulding1,2,
- Alan R Lifson1,2,
- Erik R Iverson1,2,
- Anuradha Ganesan2,3,
- Michael L Landrum2,4,
- Amy C Weintrob2,3,
- Brian K Agan2,
- Mary F Bavaro2,5,
- Robert J O'Connell6,
- Grace E Macalino2,
- the Infectious Disease Clinical Research Program HIV Working Group
- 1Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
- 2Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- 3Walter Reed National Military Medical Center, Bethesda, MD, USA
- 4San Antonio Military Health Systems, Fort Sam Houston, TX, USA
- 5Naval Medical Center, San Diego, CA, USA
- 6Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Correspondence to Alicen B Spaulding, University of Minnesota School of Public Health, 1300 S. Second Street, Suite 300, Minneapolis, MN 55454-1015, USA;
Contributors ABS was lead author responsible for planning and coordinating the analysis, and drafting interim and final versions of the manuscript. ARL provided support and assistance on aspects of the design, analysis, interpretation and drafting of the manuscript. ERI conducted the analyses and assisted with their interpretation, in addition to providing feedback on drafts of the manuscript. AG, MLL, BKA, GEM and RJO provided support and feedback on interim analyses and drafts of the manuscript. ACW, MFB and RJO helped with study implementation and data collection at the clinical sites represented in this study and provided feedback on drafts of the manuscript.
- Accepted 4 December 2011
- Published Online First 4 January 2012
Objectives To investigate the epidemiology and risk factors of gonorrhoea (GC) or chlamydia (CT) coinfection in an HIV-positive US military cohort, focusing on the time after participants' knowledge of HIV diagnosis.
Methods The authors analysed data from 4461 participants enrolled in the US Military Natural History Study cohort for GC or CT infection ≥6 months after their HIV-positive test.
Results During a mean follow-up of 7.08 years, 482 (11%) participants acquired a GC or CT infection. Of these, 283 (6%) acquired a GC infection, 278 (6%) acquired a CT infection and 123 (3%) had multiple GC or CT infections during follow-up. Risk of GC or CT infection was significantly greater in those younger, male, African–American and with a history of GC or CT infection.
Conclusions Frequent GC and CT diagnoses observed among members of this HIV-positive cohort indicate substantial ongoing risk behaviours that raise concerns for HIV transmission and underscore the need for continued screening to help identify and treat these sexually transmitted infections in this population.
Data from this research were presented in part at the Infectious Disease Society of America 48th Annual Meeting, Vancouver, Canada, 21–24 October, 2010, abstract 1433.
Funding Support for this work (IDCRP-000-26) was provided by the Infectious Disease Clinical Research Program (IDCRP), a Department of Defense program executed through the Uniformed Services University of the Health Sciences. This project has been funded in whole, or in part, with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, under Inter-Agency Agreement Y1-AI-5072. The content of this publication is the sole responsibility of the authors and does not necessarily reflect the views or policies of the NIH or the Department of Health and Human Services, the DoD or the Departments of the Army, Navy or Air Force. Mention of trade names, commercial products, or organisations does not imply endorsement by the US Government.
Correction notice This article has been corrected since it was published Online First. The sentence ‘positive GC or CT test for an overall incidence rate of 2.22/1000 PY (95% CI 1.75 to 26.9)’ has been updated to read ‘positive GC or CT test for an overall incidence rate of 22.2/1000 PY (95% CI 17.5 to 26.9)’.
Competing interests None.
Ethics approval Ethics approval was provided by Infectious Disease Institutional Review Board at the Uniformed Services University of the Health Sciences.
Provenance and peer review Not commissioned; externally peer reviewed.