The effects of incarceration on sexually transmitted infections in women with or at risk for human immunodeficiency virus in the United States

Abstract Background Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) decreases HIV transmission. Some studies have raised concerns about a potential association between the implementation of HIV PrEP and the growing incidence rates of sexually transmitted infections (STIs) in the United States. Methods We conducted a quasi-experimental (interrupted time series) analysis of STI (syphilis, gonorrhea, and chlamydia) rates before (2000–2012) and after (2013–2017) the implementation of HIV PrEP. We also performed correlations between HIV PrEP utilization and STI cases at the national (2012–2017) and state (2017) levels. We defined HIV PrEP utilization as the number of people taking tenofovir disoproxil fumarate/emtricitabine for HIV prevention. Results HIV PrEP implementation was associated with 25% (relative risk [RR] 1.254, 95% confidence interval [CI] 1.245–1.263; P < .001) and 26% (RR 1.260, 95% CI 1.257–1.264; P < .001) increases in syphilis and gonorrhea rates, respectively, and a 12% reduction in chlamydia rates (RR: 0.884, 95% CI 0.883–0.885; P < .001). HIV PrEP utilization was correlated with the numbers of syphilis, gonorrhea, and chlamydia cases (spearman coefficients 1.00, 0.94, and 0.94, respectively; P < .001, P < .01, and P < .01, respectively). At the state level, HIV PrEP was also correlated with the number of cases of syphilis, gonorrhea, and chlamydia (spearman coefficients 0.85, 0.81, and 0.85, respectively; Ps < .001 for all correlations). Conclusions The implementation and utilization of HIV PrEP in the United States were associated with increased rates of STIs. Further studies to confirm these associations and to elucidate potential causes are needed.

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Interest in multipurpose prevention technologies for protection against unintended pregnancy, human immunodeficiency virus and other sexually transmitted infections among women in the united states

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.08.074 ◽

2017 ◽

Vol 217 (6) ◽

pp. 731 ◽

Cited By ~ 1

Author(s):

J. Schreier ◽

J. Sales ◽

A. Sheth ◽

E. Lathrop ◽

L. Haddad

Keyword(s):

United States ◽

Human Immunodeficiency Virus ◽

Sexually Transmitted Infections ◽

Unintended Pregnancy ◽

The United States ◽

Sexually Transmitted ◽

Immunodeficiency Virus

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Modernizing Field Services for Human Immunodeficiency Virus and Sexually Transmitted Infections in the United States

Sexually Transmitted Diseases ◽

10.1097/olq.0000000000000652 ◽

2017 ◽

Vol 44 (10) ◽

pp. 599-607 ◽

Cited By ~ 15

Author(s):

Matthew R. Golden ◽

David A. Katz ◽

Julia C. Dombrowski

Keyword(s):

United States ◽

Human Immunodeficiency Virus ◽

Sexually Transmitted Infections ◽

The United States ◽

Sexually Transmitted ◽

Immunodeficiency Virus

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Epidemiology of Sexually Transmitted Infections among Human Immunodeficiency Virus Positive United States Military Personnel

Journal of Sexually Transmitted Diseases ◽

10.1155/2013/610258 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Jeff S. Tzeng ◽

Leslie L. Clark ◽

Eric C. Garges ◽

Jean Lin Otto

Keyword(s):

United States ◽

Human Immunodeficiency Virus ◽

Sexually Transmitted Infections ◽

Military Personnel ◽

Hiv Positive ◽

Hiv Diagnosis ◽

Military Population ◽

Sexually Transmitted ◽

Immunodeficiency Virus ◽

Hiv Seropositive

Background. Minimal data exist that describe the epidemiology of sexually transmitted infections (STI) in human immunodeficiency virus (HIV) positive populations across the pre- and post-diagnosis periods for HIV. Purpose. The purpose of this study was to identify and describe the epidemiology of gonorrhea, chlamydia, syphilis, herpes simplex virus, and human papillomavirus in an HIV-positive population. Methods. All 1,961 HIV seropositive United States active duty military personnel from 2000–2010 were identified. STI diagnoses relative to HIV diagnosis from 1995, which was the earliest electronic medical record available, to 2010 were examined. Results. The incidence diagnosis rates of STI generally increased during the period leading up to eventual HIV diagnosis. The rates of STI during the post-HIV diagnosis period fluctuated, but remained elevated compared to pre-HIV diagnosis period. Approximately 45%–69% with an STI in the HIV seropositive military population were diagnosed with their first STI greater than one year after their HIV diagnosis. Of those who were diagnosed with an STI in the post-HIV diagnosis period, 70.6% had one STI diagnosis, 23.5% had two STI diagnoses, and 5.8% had three or more STI diagnoses. Conclusions. Despite aggressive counseling, high-risk sexual behavior continues to occur in the HIV-positive military population.

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