Abstract

Background

Sexually transmitted infections (STIs) are common among people with human immunodeficiency virus (PWH), but there are limited data about risk factors and incidence of STIs in large, representative cohort studies.

Methods

We assessed incidence and risk factors of STIs reported by treating physicians within the Swiss HIV Cohort Study (SHCS). Sexually transmitted infections and demographic, clinical, and behavioral characteristics were prospectively collected at 6-month follow-up visits between October 2017 and November 2019. We used multilevel Poisson regression to assess incidence rate ratios of different STIs.

Results

Among 10 140 study participants, a total of 1634 STIs in 1029 SHCS participants were reported over 17 766 person-years of follow up (PYFUP). The overall incidence of any reported STI was 91.9 per 1000 PYFU (95% confidence interval [CI], 85.8 –98.5). Among the 1634 STI episodes, there were 573 (35.1%) incident cases of syphilis, 497 gonorrhea (30.4%), and 418 chlamydia (25.6%). Men who have sex with men (MSM) younger than 50 years represented 21% of the study population, but accounted for 61% of reported STIs. Male sex (adjusted incidence rate ratio [aIRR], 2.03; 95% CI, 1.36–3.02), MSM (aIRR, 3.62; 95% CI, 2.88–4.55), age group 18–34 years (aIRR, 1.78; 95% CI, 1.51–2.10), history of sexual relationships with occasional partners (aIRR, 6.87; 95% CI, 5.40–8.73), and reporting injecting drug use (aIRR, 2.48; 95% CI, 1.91–3.23) were associated with a higher risk of incident STIs.

Conclusions

Sexually transmitted infections were frequent among PWH and varied considerably between age and risk groups. Screening programs and recommendations for STI testing need to be adapted according to risk factors and demographic characteristics.

Details

Title
Risk Factors and Incidence of Sexually Transmitted Infections in the Swiss HIV Cohort Study
Author
Bosetti, Davide 1 ; Mugglin, Catrina 1 ; Calmy, Alexandra 2 ; Cavassini, Matthias 3 ; Stöckle, Marcel 4 ; Braun, Dominique 5 ; Notter, Julia 6 ; Haerry, David 7 ; Hampel, Benjamin 8 ; Kovari, Helen 9 ; Bernasconi, Enos 10 ; Wandeler, Gilles 11 ; Rauch, Andri 11 ; Abela, I; Aebi-Popp, K; Anagnostopoulos, A; Battegay, M; Bernasconi, E; Braun, D L; Bucher, H C; Calmy, A; Cavassini, M; Ciuffi, A; Dollenmaier, G; Egger, M; Elzi, L; Fehr, J; Fellay, J; Furrer, H; Fux, C A; Günthard, H F; Hachfeld, A; Haerry, D; Hasse, B; Hirsch, H H; Hoffmann, M; Hösli, I; Huber, M; Kahlert, C R; Kaiser, L; Keiser, O; Klimkait, T; Kouyos, R D; Kovari, H; Kusejko, K; Martinetti, G; Martinez de Tejada, B; Marzolini, C; Metzner, K J; Müller, N; Nemeth, J; Nicca, D; Paioni, P; Pantaleo, G; Perreau, M; Rauch, A; Schmid, P; Speck, R; Stöckle, M; Tarr, P; Trkola, A; Wandeler, G; Yerly, S

 Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland 
 HIV/AIDS Unit, Department of Infectious Diseases , Geneva , Switzerland 
 University Hospital of Lausanne, University of Lausanne , Lausanne , Switzerland 
 Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel , Basel , Switzerland 
 Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich , Zurich , Switzerland 
 Division of Infectious Diseases and Hospital Epidemiology , St. Gallen , Switzerland 
 Positive Council Switzerland , Switzerland 
 Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich , Zurich , Switzerland 
 Zentrum für Infektionskrankheiten, Klinik im Park , Zurich , Switzerland 
10  Ente Ospedaliero Cantonale, Lugano, University of Geneva, and University of Southern Switzerland , Lugano , Switzerland 
11  Department of Infectious Diseases, University Hospital of Geneva, University of Geneva , Geneva , Switzerland 
Publication year
2022
Publication date
Dec 2022
Publisher
Oxford University Press
e-ISSN
23288957
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3171174145
Copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.