TRENDS IN THE ACQUISITION OF SEXUALLY-TRANSMITTED DISEASES AMONG HIV-POSITIVE PATIENTS AT STD CLINICS, MIAMI 1988-1992

Background and Objectives: To assess trends in the acquisition of new sexually transmitted diseases (STDs) among patients who test positive for human immunodeficiency virus (HIV) at STD clinics. Study Design: C ohorts of HIV-positive and HIV-negative persons were compared using co mputerized records from Miami STD clinics for 1988-1992. Persons were assigned to cohorts according to their first positive or first negativ e HIV test results, New STDs were defined if persons had new diagnoses of gonorrhea, primary or secondary syphilis, chancroid, or lymphogran uloma venereum; were undergoing treatment as contacts for syphilis or gonorrhea; or were undergoing epidemiologic treatment for syphilis or gonorrhea. Results: Of the 103,549 persons who visited the clinics, 53 ,467 were tested for HIV, and 5,615 had results that were positive, Th e percentages returning with new STDs were similar for the HIV-positiv e and HIV-negative cohorts, and both decreased over time, For the 1988 cohorts, 26% of those testing positive and 30% of those testing negat ive for HIV returned with at least one STD within 5 years. Returns wit h STD within 1 year decreased from 16% in 1988 to 3% in 1992. Conclusi ons: Returns decreased dramatically among HIV-positive cohorts; howeve r, there were similar decreases of new STDs among HIV-negative cohorts , so the decrease may have been caused by the decreasing prevalence of bacterial STD in the community rather than by behavioral changes amon g HIV-positive persons.