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New sexually transmitted infections among adolescent girls infected with HIV
  1. Maria Trent1,
  2. Shang-en Chung1,
  3. Jonathan M Ellen1,
  4. Gretchen Clum2,
  5. and the Adolescent HIV/AIDS Trials Network
  1. 1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  2. 2Department of Community Health Sciences, Tulane School of Public Health, New Orleans, Louisiana, USA
  1. Correspondence to:
 Dr Maria Trent
 MD, MPH, Assistant Professor of Pediatrics, Johns Hopkins School of Medicine, 200 N. Wolfe Street, Office #2064, Baltimore, MD 21287, USA; mtrent2{at}


Objectives: Although the prevalence of sexually transmitted infections (STIs) among girls infected with HIV has been reported, the incidence of STI diagnoses has not been well documented. The objectives of this study were to examine (1) incident STI diagnoses and (2) the association between viral load (VL) and incident STI diagnosis among HIV-infected adolescent girls in care.

Methods: This was a prospective longitudinal 18-month study of girls enrolled in the Adolescent HIV trials network. Cox proportional hazard modelling was performed to evaluate the incidence of STI by baseline viral load.

Results: The mean (SD) age of participants was 20.6 (2.0) years, viral load of participants was 66 917 (165 942) copies/ml and median viral load was 7096 copies/ml. The incidence of STIs for the entire cohort was 1.4 per 100 person-months. During the 18-month follow-up period, there were no significant differences in the STI incidence between the high and low viral load groups (hazard ratio (HR) = 0.86, 95% CI 0.37 to 1.95) There was also no significant association between STI incidence and log-transformed viral load (HR  = 1.10, 95% CI 0.92 to 1.3).

Conclusions: Adolescent girls with HIV infection continue to acquire sexually transmitted infections after diagnosis. This analysis does not suggest that VL is a critical factor in STI acquisition over time. Additional work exploring the role of other contextual factors on STI acquisition among HIV-infected adolescent girls is warranted.

  • ATN, Adolescent HIV Trials Network
  • CT, Chlamydia trachomatis, GEE, generalised estimating equations
  • HPV, human papilloma virus
  • HSV, herpes simplex viruses
  • NG, Neisseria gonorrhea
  • STI, sexually transmitted infection
  • VL, viral load
  • adolescence
  • HIV
  • sexually transmitted infection (STI)

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  • Competing interests: None declared