STD screening among HIV-infected patients in care, San Francisco

The Centers for Disease Control and Prevention recommends sexually transmit ted disease (STD) screening among human immunodeficiency virus (HIV)-infect ed persons as a means of HIV prevention. HIV-infected persons in care may b e an important target group in which to conduct regular STD screening to pr event enhanced transmission of HIV. We conducted STD screening for syphilis and two causes of urethritis, chlamydia, and gonorrhea, among 447 HIV-infe cted persons at two busy, urban clinics in San Francisco: a general HIV acq uired immune deficiency syndrome (AIDS) care clinic and a methadone mainten ance clinic. There were no new cases of syphilis identified and only two pr evalent cases of chlamydia. While STD screening was feasible and acceptable in this population, the benefits of screening for asymptomatic gonococcal and chlamydial infection remain to be determined. Because these two pathoge ns only cause about 20% of urethritis, broader screening tests for urethrit is, e.g., leukocyte esterase or urine microscopy, may be more useful. Final ly, this study reaffirms the notion that local data should be used to evalu ate national screening recommendations.