THE RISK OF SEXUALLY-TRANSMITTED DISEASES IN HUMAN-IMMUNODEFICIENCY-VIRUS INFECTED PARTURIENTS

OBJECTIVE: We assessed the prevalence of and defined the relationship between other sexually transmitted diseases and human immunodeficiency virus infection. STUDY DESIGN: We performed a case-control study amon g 121 human immunodeficiency virus-infected and 222 randomly selected seronegative parturient women. These women were identified from a pren atal population undergoing routine voluntary antibody screening in a l arge urban hospital in the southeastern United States. RESULTS: During the 24-month study period, 16,868 women consented to human immunodefi ciency virus antibody screening; 121 (7.2/1000) were infected with hum an immunodeficiency virus. Cases were significantly more likely than c ontrols to be infected with at least one sexually transmitted disease during pregnancy (48% vs 21%; odds ratio 3.4, 95% confidence interval 2.1 to 5.7). The prevalence of Chlamydia trachomatis and hepatitis B i nfection did not differ significantly among the groups. Cases were sig nificantly more likely than controls to be infected with Treponema pal lidum (29% vs 4%; odds ratio 9.6, 95% confidence interval 4.2 to 22.4) . This relationship persisted after we controlled for confounding risk factors (odds ratio 9.2, 95% confidence interval 2.1 to 13.3). In add ition, cases were significantly more likely than controls to be infect ed with Neisseria gonorrhoeae (17.2% vs 4%, odds ratio 5.2, 95% confid ence interval 2.1 to 13.3). This relationship also persisted after we controlled for confounders (odds ratio 3.7, 95% confidence interval 1. 4 to 10.0). CONCLUSION: Human immunodeficiency virus-infected parturie nt women in our center are at substantial risk of having other sexuall y transmitted diseases.