Sexually transmitted infections in individuals with a recent HIV diagnosis
Abstract
Introduction: Sexually transmitted infections (STIs) are common among individuals with a recent diagnosis of HIV and maintain a bidirectional relationship with this infection. During the initial clinical evaluation, endogenous diseases of the genital tract and genital clinical syndromes may also be identified, which can influence genital inflammation, clinical presentation, and the comprehensive management of people living with HIV.
Objective: To describe the frequency and characteristics of STIs in patients with a recent HIV diagnosis, as well as associated endogenous genital tract diseases and genital clinical syndromes identified concomitantly.
Materials and Methods: A descriptive, retrospective, cross-sectional study was conducted. A total of 2,190 records of adults with a recent HIV diagnosis, detected between 2019 and 2023, who were attended at the Comprehensive Care Unit for HIV and Chronic Infections of Roosevelt Hospital, were analyzed. Data were
analyzed using Python 3.11. Descriptive statistics were applied using medians, interquartile ranges, frequencies, and percentages. The association between sexual orientation and the presence of STIs was assessed using binary logistic regression, estimating odds ratios (OR) with 95% confidence intervals (95% CI). Results: Male sex predominated (79.2%); within this group, 46.0% were homosexual men and 24.9% were bisexual men. The median age was 33 years, baseline CD4+ count was 235 cells/µL, and viral load was 103,000 copies/mL. In women, genital papillomatosis (5.3%) and syphilis (2.4%) were the most frequent STIs; vaginosis was identified in 18.9%. In men, syphilis predominated among homosexual (19.3%) and bisexual men (19.5%) compared to heterosexual men (3.4%), with an OR ≈ 6.8. Individually, genital clinical syndromes did not exceed 2% in the evaluated men.
Conclusion: The frequency of STIs in patients with a recent HIV diagnosis highlights the need to strengthen early and targeted screening strategies, as well as to promote consistent condom use. Additionally, the concomitant identification of endogenous genital tract diseases and associated clinical syndromes underscores the importance of a comprehensive clinical approach, particularly in contexts of immunosuppression.
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