Table 1

Summary of findings from studies of sexually transmitted co-infections in people living with HIV/AIDS

Study authors, date	Sample—all HIV+	% Receiving ART	STI diagnosis/detection	STI point prevalence	STI time interval prevalence
Africa and Middle East
Machekano et al, 200027	666 Men factory workers, Zimbabwe	NR	Presentation with urethral discharge, genital ulcer, genital warts, or other	11% Genital ulcers 5% Urethral discharge
Aboud et al, 20085	2292 Pregnant women enrolled in an HIV prevention trial, Malawi, Tanzania, Zambia	NR	External examination, serology, Gram stain	47.8% Bacterial vaginosis 2.6% Chlamydia 2.2% Genital ulcer 1.7% Gonorrhoea 18.8% Trichomoniasis
Agmon-Levin et al, 201028	1060 Patients receiving HIV-related care, Israel	NR	Clinical records and serology		14% Syphilis
Asia
Zhang et al, 200729	16 Men, VCT centre, China	None, initial test	Serology	31% Chlamydia 50% Syphilis
Park et al, 200830	539 Patients at HIV clinics, Republic of Korea	100% Taking HAART	Serology	10% Early syphilis 3% Primary syphilis 7% Secondary syphilis
Lee et al, 200931	116 Men and 7 women attending HIV clinic, China	NR	Self-reported history, medical records, serology and urine screening	8.9% Had active STD at enrolment	19.5% New STI since HIV diagnosis
Sirivongrangson et al, in press	131 MSM STI clinic patients, Thailand	16%	Clinical examination, PCR, serology	10% Chlamydia 13% Gonorrhoea 9% Syphilis reactive 10% Genital ulcers
Australia
Jin et al, 200732	235 Men in the Positive Health Cohort Australia	NR	Serology, urine and anal screening	5.9% Anal chlamydia 2.2% Urethral chlamydia 3.2% Anal gonorrhoea 18.6% Syphilis reactive
Europe
Stolte et al, 200633	222 Men, STD clinic patients, The Netherlands	None	Serology and culture	15.8% Rectal gonorrhoea 9.9% Infectious syphilis
Kofoed et al, 200624	2200 Infectious disease patients, Denmark	83% of Syphilis patients taking ART	Serology		2% Syphilis cases diagnosed in 1 year
Dodds et al, 200734	257 Men, venue surveys, 3 cities in UK London n=176 Brighton n=51 Manchester n=30	NR	Self-report STI diagnosis in past year		STI in the past year London 38% Brighton 43% Manchester 35%
Landes et al 200735	1050 Pregnant women, seven countries in Europe	80% Antenatal ART	Clinical and laboratory	Diagnosed during pregnancy 1% Gonorrhoea/chlamydia 2% Syphilis 12% Trichomoniasis
Diaz et al, 200936	1462 MSM diagnosed with HIV between 2003 and 2007 in Spain	NA	Clinical diagnosis	31% Diagnosed with chlamydia, gonorrhoea or syphilis at time of testing HIV positive
Branger et al, 200937	1105 HIV clinic patients with history of syphilis testing, The Netherlands	NR	Serology	6.2% Syphilis (33% asymptomatic)
Dang et al, 200938	147 Men, Swiss HIV Cohort Study, Switzerland	71% Combination ART	Anal swab specimens screened for Chlamydia trachomatis by PCR; self-reported STI history	10.9% C trachomatis 2.7% Gonorrhoea 43% Syphilis reactive
North America
Niccolai et al, 200039	1407 Women at public HIV outpatient clinic, USA	NR	Clinical diagnosis trichomoniasis, gonorrhoea, chlamydia and primary or secondary syphilis	27% A concurrent STI 29% Trichomoniasis 36% Re-infected with trichomoniasis
Kalichman et al, 200040	223 Men, 112 women, 5 transgender recruited from community services, USA	NR	Self-reported		3-Month retrospective Men 3% Chlamydia 4% Gonorrhoea 3% Incident HSV 3% Syphilis 1% Trichomoniasis Women 4% Chlamydia 6% Gonorrhoea 6% Incident HSV 4% Syphilis 9% Trichomoniasis
Cu-Uvin et al, 200122	108 Women, research site, USA	30% Untreated 25% Non-HAART 45% HAART	Clinical diagnosis and culture	11% Bacterial vaginosis 4% Trichomoniasis
Scheer et al, 200141	11 516 People living with AIDS in San Francisco data extracted from central STI registry, USA	79% Received HIV therapy	Clinical reports to central registry of chlamydia, gonorhrhea, non-gonococcal urethritis, syphilis		2% Diagnosed with STI after AIDS diagnosis Of those with STI 5% Chlamydia 84% Gonorhrhea 7% Non-gonococcal urethritis 3% Syphilis
Do et al, 200142	36 102 Patients attending over 100 health clinics, USA between 1991 and 1998	62% Received HIV therapy	Culture, Gram-stain	1.6% Urogenital gonorrhoea infection
Cu-Uvin et al, 200243	871 Women in HERS Cohort – patients in health clinics in 4 cities, USA	NR	Microscopic evaluation, culture	47% Bacterial vaginosis 29% Trichomoniasis estimated
Whittington et al, 200244	337 Men receiving public health clinic services and recruited from other sites, USA	NR	Serology and urine screening	STD clinics 15% Gonorrhoea or chlamydia Other recruitment sites 8% Gonorrhoea or chlamydia 2% Syphilis
Erbelding et al, 200345	796 Men and 354 women public STI clinic patients, USA	NA	Clinical records from routine testing services	Co-infection at time of testing Men 14% Gonorrhoea 19% Non-gonococcal urethritis 21% Syphilis Women 9% Gonorrhoea 18% Syphilis 20% Trichomoniasis
Bachmann et al, 200546	338 Men, HIV clinic, USA	76% HAART	Pharynx and rectal swabs; urine samples, cultures and PCR	3% Chlamydia 1.5% Gonorrhoea
Phipps et al, 200547	814 Primary care HIV patients, USA	NR	Serology, urine screening, pharyngeal and anal swabs	10% Gonorrhoea/chlamydia 1.8% Syphilis
Kahle et al, 200748	4711 Patients at HIV clinics and hospitals, USA	74% History of HIV treatment	Serology, Gram stain, culture, self-report and referral		1 Year interval 2% Chlamydia 4% Gonorrhoea 1% Syphilis
Manning et al, 200749	632 264 People living with HIV/AIDS in New York City data extracted from central STI registry, USA	NR	Clinical reports to central registry		People living with HIV 5% of Men 2.5% Women People living with AIDS 1.8% Men 1.4% Women Frequency of diagnoses among people living with HIV/AIDS With 2-year cumulative STI 20% Chlamydia 42% Gonorrhoea 31% Syphilis 5% Multiple STI 16% Repeated STI
Sena et al, 200850	1460 Newly diagnosed men and 2142 newly diagnosed women from public testing sites, USA	NA	Serology and clinical records	7% Syphilis, men 13% Syphilis, women
Rieg et al, 200851	212 Men receiving medical care at 2 HIV clinics, USA	NR	Serology, urine screening, self-report	6% Gonorrhoea 5% Chlamydia
Mayer et al, 200952	398 Men screened at a community research site, USA	66% ART	Medical records of clinical examination, serology, PCR,		STI in past year >1% Chlamydia 3.1% Gonorrhoea 6.4% Syphilis
Horberg et al, 200953	622 Patients in an integrated healthcare system, USA	51% Treated	Laboratory database searched for serological test results	12.4% Syphilis
Kalichman et al, 200954	320 Men, 137 women, 33 transgender recruited from community services, USA	71% Treated	Self-reported STI		STI diagnosis in past 6 month 14% New chlamydia, gonorrhoea, HSV, or syphilis STI diagnosis since testing HIV+ 20% Chlamydia 13% Gonorrhoea 37% HSV 36% Syphilis
Romanowski et al, 200955	455 Men, 174 women infectious disease clinic patients, Canada	77% Men, 60% women HAART	HSV-1 and HSV-2 serology	78% HSV-1 positive 54% HSV-2 positive 58% of HSV-2 positive without genital herpes symptoms
McCoy et al, 20096	56 Men and 19 women with acute HIV infection, USA	NA	Clinical confirmed diagnosis	30.6% Co-infected with STI Men >1% Chlamydia 12% Gonorrhoea 7% Syphilis Women 15% Bacterial vaginosis 10% Chlamydia 10% Gonorrhoea 26% Trichomoniasis
South America
Griemberg et al, 200656	87 HIV-positive patients detected in clinics/hospitals, Argentina	NA	Clinical diagnosis	58% Syphilis reactive at time of testing
Grinsztejn et al, 200657	458 Women receiving care, Brazil	67%	Clinical diagnosis	7.0% Trichomoniasis 0.9% Neisseria gonorrhoeae 3.0% C trachomatis 3.1% HSV 13.8% Syphilis 22.8% Bacterial vaginosis
Caribbean
Hutton-Rose et al, 200858	138 Men and 132 women referral clinic, Jamaica	NR	History, clinical examination, and lab diagnosis	Men 4% Chancroid 19% Gonorrhoea 19% Non-gonococcal urethritis 8% Syphilis 9% Trichomoniasis 14% Genital ulcer Women 10% Bacterial vaginosis 2% Chancroid 15% Gonorrhoea 19% Non-gonococcal urethritis 6% Syphilis 15% Trichomoniasis 7% Genital ulcer

ART, antiretroviral therapy; HAART, highly active antiretroviral therapy; HSV, herpes simplex virus; MSM, men who have sex with men; STD, sexually transmitted disease; STI, sexually transmitted infection; VCT, voluntary counselling and testing.