An. Do et al., Risk factors for and trends in gonorrhea incidence among persons infected with HIV in the United States, AIDS, 15(9), 2001, pp. 1149-1155
Objective: To determine the risk factors for and trends in gonorrhea infect
ions among HIV-infected persons.
Design: Longitudinal review of medical records of HIV-infected patients.
Methods: We analyzed data about HIV-infected patients obtained from 1991 to
1998 in over 100 facilities participating in the Adult/Adolescent Spectrum
of HIV Disease Project.
Results: The overall incidence of gonorrhea was 9.5 cases per 1000 person-y
ears. Factors associated with higher gonorrhea incidence (P < 0.01) include
d younger age, male-male sex, black race, HIV infection without AIDS (namel
y AIDS-defining opportunistic illness or CD4 cell count < 200 x 10(6) cells
/l), and recent recreational use of injection or non-injection drugs. There
was an increase in the trend among men who have sex with men (P < 0.01) an
d a decrease in the trend among patients with heterosexual contact as their
HIV exposure risk (P < 0.01). Among injection drug users there was no sign
ificant trend from 1991 to 1996, but there was an increase in gonorrhea inc
idence from 6.6 cases/1000 person-years in 1997 to 16.3 cases/1000 person-y
ears in 1998.
Conclusions: Following HIV diagnosis, some individuals continue to practice
risky sexual behaviors which result in gonorrhea and may transmit HIV. The
increase in the trend in gonorrhea incidence among HIV-infected men who ha
ve sex with men is of particular concern because it suggests an increase in
risky sexual behaviors. These findings indicate a need for effective HIV p
revention strategies that involve reducing risky sexual behaviors in HIV-in
fected persons. (C) 2001 Lippincott Williams & Wilkins.