Incidence and predictors of sexually transmitted infections among adult HIV-positive patients receiving antiretroviral therapy at Themba Lethu HIV clinic in Johannesburg, South Africa

• Published in: South African medical journal 2021-01, Vol.111 (1), p.80
• Main Authors: Onoya, D, Manjengwa, P, Nattey, C, Kgowedi, S, Mbele, M, Shumba, K, Fox, M.P
• Format: Article
• Language: English
• Subjects: Complications and side effects; Drug therapy; HIV infection; Risk factors; Sexually transmitted diseases; Statistics
• ISSN: 0256-9574
• DOI: 10.7196/SAMJ.2021.v111i1.14672

Background. Sexually transmitted infections (STIs) among people living with HIV/AIDS can facilitate the spread of HIV. Objectives. To estimate STI incidence and identify predictors of STI acquisition among HIV-positive patients during their first 24 months of antiretroviral therapy (ART) in Johannesburg, South Africa. Methods. We conducted a cohort study using prospectively collected routine data on patients who initiated ART between January 2004 and January 2015 at the Themba Lethu HIV clinic in Johannesburg. Kaplan-Meier analysis was used to estimate STI incidence rates (based on evidence of laboratory diagnosis and STI syndromic treatment prescription records). STI predictors were identified using Cox regression analysis. Results. Among 26 762 adult patients on ART, there were 1 906 (7.1%) cases of STI (incidence 4.8/100 person-years; 95% confidence interval (CI) 4.7-5.1). Non-pregnant women were 60% more likely than men to be diagnosed with an STI (adjusted hazard ratio (aHR) 1.6; 95% CI 1.4-1.8). The risk of STI decreased with increasing baseline CD4 count (aHR 0.8, 0.5 and 0.4 for CD4 counts 101-200, 201-350 and >350 cells/[micro]L, respectively, compared with CD4 count