Background: Co-infection of HIV and other sexualLy transmitted diseases (STDs) is common. The Centers for Disease Control and Prevention (CDC) recommends routine yearly screening for STDs in HIV carriers. There is only scarce data on the prevalence of STD in HIV positive individuals in Israel and no current recommendations on this issue are available.
Objectives: To evaluate the prevalence of STDs, in HIV positive females attending the HIV Clinic at the Soroka University Medical Center in Beer Sheva and to compare prevalence and risk factors for STDs between HIV female carriers of Ethiopian and non-Ethiopian origin.
Methods: Eighty five HIV-positive women were enrolled in the study. Demographic data and sexual behavior were obtained and medical records were reviewed. Cervical swabs for Neisseria gonorrhoeae, Herpes simplex 1 and 2, Ureaplasma urealyticum and Mycoplasma hominis and serum samples for hepatitis B, C and syphilis were obtained.
Results: Thirty two of the study participants (37.6%) had at least one STD and in eleven cases (12.9%) two or more STDs were found. Ureaplasma urealyticum was the most frequent pathogen (29.4%). Prevalence for Mycoplasma hominis, HSV1 and 2, Neisseria gonorrhoeae, syphilis and HBV was low. Despite significant differences in sexual behavior between women of Ethiopian and non-Ethiopian origin there were no differences in the prevalence of STDs in the two groups. HCV was significantly more prevalent in women of non-Ethiopian origin, due to high use of intravenous drugs in this group. There was no correlation between CD4 levels and the prevalence of STDs in both groups.
Discussion and conclusion: A relatively low prevalence of STDs among female HIV carriers was found, despite low condom use. The exclusion of males in this study may have contributed to this. The most frequent pathogen found in this study was asymptomatic Ureaplasma urealyticum (29.4%). As this pathogen may cause premature delivery and fetal death it seems important to routinely screen HIV-positive fertile women for its presence. A nationwide multicenter study of HIV-positive females and males is needed in order to establish the prevalence of STDs in this population in Israel and to recommend a screening policy.