Abstract
Objectives: To compare the rate of self reported sexually transmitted diseases (STDs) among HIV infected men with men who remained HIV negative during follow up of a Harare male factory cohort.
Methods: Male factory workers were offered enrolment and behavioural data were collected at entry then every 6 months, along with HIV testing. Self report of STDs was used to calculate incidence per 100 person years. Cox proportional hazards models examined independent risk factors for STDs, with hazard ratios (HRs).
Results: At entry 20% of men were HIV infected and 11% reported STDs in the previous year. A total of 2777 (82%) of 3383 men enrolled were followed at least once. Compared with men who remained HIV negative, seroconverters had the highest incidence of STDs (16.8 per 100 person years; IRR= 3.3, 95% CI=2.5–4.3); men enrolled HIV positive also reported higher STD incidence (14.5 per 100 person years, IRR=2.8; 95%CI 2.3–5.5). Among HIV positive men, the only independent risk factor for report of urethral discharge was history of multiple partners (HR=10, 95%CI 1.4–73.2).
Conclusion: HIV positive men reported threefold higher incidence of STDs than HIV negative men, many related to high risk sexual behaviour.
Key Words: AIDS; sexually transmitted diseases; HIV; Zimbabwe
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- Anzala O. A., Nagelkerke N. J., Bwayo J. J., Holton D., Moses S., Ngugi E. N., Ndinya-Achola J. O., Plummer F. A. Rapid progression to disease in African sex workers with human immunodeficiency virus type 1 infection. J Infect Dis. 1995 Mar;171(3):686–689. doi: 10.1093/infdis/171.3.686. [DOI] [PubMed] [Google Scholar]
- Bassett M. T., McFarland W. C., Ray S., Mbizvo M. T., Machekano R., van de Wijgert J. H., Katzenstein D. A. Risk factors for HIV infection at enrollment in an urban male factory cohort in Harare, Zimbabwe. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Nov 1;13(3):287–293. doi: 10.1097/00042560-199611010-00012. [DOI] [PubMed] [Google Scholar]
- Chilongozi D. A., Daly C. C., Franco L., Liomba N. G., Dallabetta G. Sexually transmitted diseases: a survey of case management in Malawi. Int J STD AIDS. 1996 Jul;7(4):269–275. doi: 10.1258/0956462961917951. [DOI] [PubMed] [Google Scholar]
- Cohen D. A., Dent C., MacKinnon D., Hahn G. Condoms for men, not women. Results of brief promotion programs. Sex Transm Dis. 1992 Sep-Oct;19(5):245–251. doi: 10.1097/00007435-199209000-00002. [DOI] [PubMed] [Google Scholar]
- Cohen M. S., Hoffman I. F., Royce R. A., Kazembe P., Dyer J. R., Daly C. C., Zimba D., Vernazza P. L., Maida M., Fiscus S. A. Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. AIDSCAP Malawi Research Group. Lancet. 1997 Jun 28;349(9069):1868–1873. doi: 10.1016/s0140-6736(97)02190-9. [DOI] [PubMed] [Google Scholar]
- Downing R. G., Otten R. A., Marum E., Biryahwaho B., Alwano-Edyegu M. G., Sempala S. D., Fridlund C. A., Dondero T. J., Campbell C., Rayfield M. A. Optimizing the delivery of HIV counseling and testing services: the Uganda experience using rapid HIV antibody test algorithms. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Aug 1;18(4):384–388. doi: 10.1097/00042560-199808010-00011. [DOI] [PubMed] [Google Scholar]
- Faxelid E., Tembo G., Ndulo J., Krantz I. Individual counseling of patients with sexually transmitted diseases. A way to improve partner notification in a Zambian setting? Sex Transm Dis. 1996 Jul-Aug;23(4):289–292. [PubMed] [Google Scholar]
- Grosskurth H., Mosha F., Todd J., Mwijarubi E., Klokke A., Senkoro K., Mayaud P., Changalucha J., Nicoll A., ka-Gina G. Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial. Lancet. 1995 Aug 26;346(8974):530–536. doi: 10.1016/s0140-6736(95)91380-7. [DOI] [PubMed] [Google Scholar]
- Hitchcock P., Fransen L. Preventing HIV infection: lessons from Mwanza and Rakai. Lancet. 1999 Feb 13;353(9152):513–515. doi: 10.1016/S0140-6736(99)00031-8. [DOI] [PubMed] [Google Scholar]
- Machekano R., McFarland W., Mbizvo M. T., Bassett M. T., Katzenstein D., Latif A. S. Impact of HIV counselling and testing on HIV seroconversion and reported STD incidence among male factory workers in Harare, Zimbabwe. Cent Afr J Med. 1998 Apr;44(4):98–102. [PubMed] [Google Scholar]
- Marks G., Burris S., Peterman T. A. Reducing sexual transmission of HIV from those who know they are infected: the need for personal and collective responsibility. AIDS. 1999 Feb 25;13(3):297–306. doi: 10.1097/00002030-199902250-00001. [DOI] [PubMed] [Google Scholar]
- Mbizvo M. T., Machekano R., McFarland W., Ray S., Bassett M., Latif A., Katzenstein D. HIV seroincidence and correlates of seroconversion in a cohort of male factory workers in Harare, Zimbabwe. AIDS. 1996 Jul;10(8):895–901. doi: 10.1097/00002030-199607000-00013. [DOI] [PubMed] [Google Scholar]
- McKenna S. L., Muyinda G. K., Roth D., Mwali M., Ng'andu N., Myrick A., Luo C., Priddy F. H., Hall V. M., von Lieven A. A. Rapid HIV testing and counseling for voluntary testing centers in Africa. AIDS. 1997 Sep;11 (Suppl 1):S103–S110. [PubMed] [Google Scholar]
- Plummer F. A. Heterosexual transmission of human immunodeficiency virus type 1 (HIV): interactions of conventional sexually transmitted diseases, hormonal contraception and HIV-1. AIDS Res Hum Retroviruses. 1998 Apr;14 (Suppl 1):S5–10. [PubMed] [Google Scholar]
- Vernazza P. L., Eron J. J., Fiscus S. A., Cohen M. S. Sexual transmission of HIV: infectiousness and prevention. AIDS. 1999 Feb 4;13(2):155–166. doi: 10.1097/00002030-199902040-00003. [DOI] [PubMed] [Google Scholar]
- Zwi A. B., Cabral A. J. Identifying "high risk situations" for preventing AIDS. BMJ. 1991 Dec 14;303(6816):1527–1529. doi: 10.1136/bmj.303.6816.1527. [DOI] [PMC free article] [PubMed] [Google Scholar]