Demographic, clinical and social factors associated with human immunodeficiency virus infection and other sexually transmitted diseases in a cohort of women from the United Kingdom and Ireland

Background Clinical experience suggests many women with HIV infection have experienced no other sexually transmitted diseases (STD). Our objective was to test the hypothesis that a substantial proportion of women with HIV inf ection in the United Kingdom and Ireland have experienced no other diagnose d STD and to describe the demographic, clinical and social factors associat ed with the occurrence of other STD in a cohort of HN infected women. Method Analysis of cross-sectional baseline data from a prospective study o f 505 women with diagnosed HIV infection. The setting was 15 HIV treatment centres in the United Kingdom and Ireland. The main outcome measures were o ccurrence of other STD diagnosed for the first time before and after HIV di agnosis. Data were obtained from interview with women and clinic notes. We particularly focused on occurrence of gonorrhoea, chlamydia and trichomonia sis after HIV diagnosis, as these are the STD most likely to reflect recent unprotected sexual intercourse. Results The women were mainly infected via heterosexual sex (n = 304), and injection drug use (n = 174). 151 were black Africans. A total of 250(49.5% ) women reported never having been diagnosed with an STD apart from HIV, 25 5(50.5%) women had ever experienced an STD besides HIV, including 109(21.6% ) who had their first other STD diagnosed after HIV. Twenty-five (5%) women reported having had chlamydia, gonorrhoea or trichomoniasis diagnosed for the first time after HIV diagnosis, possibly reflecting unprotected sexual intercourse since HIV diagnosis. In all 301(60%) women reported having had sex with a man in the 6 months prior to entry to the study. Of these, 168(5 8%) reported using condoms 'always', 66(23%) 'sometimes' and 56(19%) 'never '. Conclusions Half the women in this study reported having never experienced any other diagnosed STD besides HIV. However, after HIV diagnosis most wome n remain sexually active and at least 5% had an STD diagnosed which reflect unprotected sexual intercourse.