HIV and STD co-infection in Baltimore City, 2004-2008

Background: Previous studies indicated high rates of STD co-infection among HIV-positive individuals.

Methods: The study is a retrospective record-based cohort study of Baltimore City residents who tested HIV-positive for first time in 2004. These individuals were examined for STD co-infection through 2008. Co-infected individuals were analyzed to determine demographic characteristics, risk behavior and post-test counseling rates.

Results: The study identified 424 Baltimore City residents who tested HIV-positive for the first time in 2004. Fifty-six (13.2%) were diagnosed with an STD after their HIV diagnosis. These 56 co-infected individuals had an average age of 30 years, 71.4% were male, 94.6% were African American, 66.1% were tested for HIV in an STD clinic setting, and 73.2% received post-test counseling following their positive HIV test. In total, there were 93 unique occurrences of STD infection among these 56 individuals, indicating re-infection of some individuals. Twenty-one individuals (37.5%) had reoccurrences of STD infection, meaning more than one STD infection over the period of the study. These 21 re-infected individuals had an average age of 28 years, 66.7% were male, 100% were African American, 71.4% were tested for HIV in an STD clinic setting and 85.7% received post-test counseling. Among these 21, 42.8% reported heterosexual contact, 38.1% identified as MSM and 9.5% reported working in the commercial sex industry.

Conclusions: Rates of STD co-infection were high among people who previously tested positive for HIV. The reoccurrence of STD co-infection among several HIV-positive individuals was substantial, even among individuals who received post-test counseling for HIV infection.