Exploring the Relationship Between Sexually Transmitted Diseases and HIV Acquisition by Using Different Study Designs

• DOI: 10.1097/qai.0b013e318195bd2b
• Publication Date: 2009-05-21T12:43:18Z
• Authors: Nicola M Zetola; Kyle T Bernstein; Ernest Wong; Brian Louie; Jeffrey D Klausner
• Keywords: Odds

Background: It is hypothesized that sexually transmitted diseases (STDs) increase the risk of HIV acquisition. Yet difficulties establishing an accurate temporal relation and controlling confounders have obscured this relationship. In attempt to overcome prior methodologic shortcomings, we explored use different study designs examine relationship between STDs Methods: Acutely HIV-infected patients were included as cases compared with (1) HIV-uninfected (matched case-control), (2) newly diagnosed chronically (infected analysis), (3) themselves at clinic visits when they tested negative (case crossover). We used t tests compare average number logistic regression determine independent correlates odds acute infection. Results: Between October 2003 March 2007, 13,662 male who had sex men for infection San Francisco's municipal STD 350 infections (2.56%) diagnosed. Among patients, 36 (10.3%) identified acute. found consistently higher having within 12 months [matched case-control, ratio 5.2 (2.2-12.6); infected analysis, 1.4 (1.0-2.0); case crossover, 1.3 (0.5-3.1)] 3 34.5 (4.1-291.3); 2.3 (1.1-4.8); 1.8 (0.6-5.6)] before testing among acutely patients. concurrent rectal gonorrhea [17.0 (2.6-111.4), P < 0.01] or syphilis [5.8 (1.1-32.3), = 0.04] those Conclusions: Acute was associated a recent STD, particularly gonorrhea, clinic. Given complex infection, no single design will appropriately control all possible confounders; studies using complementary are required.