Report of sexually transmitted diseases by HIV infected men during follow up: time to target the HIV infected?

Objectives: To compare the rate of self reported sexually transmitted disea ses (STDs) among HIV infected men with men who remained HIV negative during follow up of a Harare male factory cohort. Methods: Male factory workers were offered enrolment and behavioural data w ere collected at entry then every 6 months, along with HIV testing. Self re port of STDs was used to calculate incidence per 100 person years. Cox prop ortional hazards models examined independent risk factors for STDs, with ha zard ratios (HRs). Results: At entry 20% of men were HIV infected and 11% reported STDs in the previous year. A total of 2777 (82%) of 3383 men enrolled were followed at least once. Compared with men who remained HIV negative, seroconverters ha d the highest incidence of STDs (16.8 per 100 person years; IRR= 3.3, 95% C I=2.5-4.3); men enrolled HIV positive also reported higher STD incidence (1 4.5 per 100 person years, IRR=2.8; 95% CI 2.3-5.5). Among HIV positive men, the only independent risk factor for report of urethral discharge was hist ory of multiple partners (HR=10, 95% CI 1.4-73.2). Conclusion: HIV positive men reported threefold higher incidence of STDs th an HIV negative men, many related to high risk sexual behaviour.