Study Recommends Simultaneous Testing for HIV, STIs

When testing patients for HIV, healthcare professionals should also test for sexually transmitted infections (STIs), a study published May 16, 2014, in Sexually Transmitted Infections recommends.

Mark Laurie and colleagues at Brown University analyzed the clinical records of 1,465 South African HIV patients taking antiretroviral therapy (ART). By examining the records of patients’ clinical visits, the researchers compared STI treatment rates pre- and post-ART.

Of the 1,465 patients, 131 sought STI treatment on 232 recorded occasions, and of those occasions, 203 (87%) transpired prior to the initiation of ART.

“Individuals had, on average, a 7-fold higher rate of seeking treatment for STIs in the period prior to initiating ART (9.57 per 100 person-years) compared with the period once on ART (5.5 per 100 person-years),” the authors wrote.

The investigators also found HIV-positive males and HIV patients under 25 years old were more likely to seek treatment for STIs, while advanced-stage HIV patients were less likely to seek treatment. However, the study did not delve into why HIV patients are less likely to seek STI treatment after undergoing ART.

In light of their data, the authors recommended that HIV and STI testing be conducted simultaneously. According to Laurie, STIs are less common after undergoing ART, so the period before treatment is especially important.

“There’s a whole population of people out there right now who may or may not know about their HIV infection status, have a co-infection with an STI, and are highly likely to transmit both HIV and their co-occurring STI to a sexual partner,” he said in a statement. Thus, the investigators stressed the importance of proactive STI testing.

“The high rates of STIs that we observed among people already infected with HIV during the period prior to ART initiation represents an important opportunity for prevention and suggests a more comprehensive approach to HIV transmission is needed beyond ART,” the study authors concluded. “Systematically including STI detection and treatment in the standard of care for people living with HIV will likely result in both a reduction in further transmission and increased viral suppression once people are on ART.”