To determine the prevalence of sexually transmitted diseases (STDs), we screened 107 human immunodeficiency virus-positive patients in Peru, where the virus is predominantly sexually transmitted. Patients had multiple risk factors for STDs, and 38% of women and 50% of men had at least 1 STD (gonorrhea, trichomoniasis, herpes simplex, anogenital watts, or syphilis seropositivity). No chlamydial infection was detected, even though infection rates in the general population are 5%-12%. Patients receiving trimethoprim-sulfamethoxazole (TMP-SMZ) for prophylaxis or treatment of respiratory infections were least likely to have cervicitis and/or urethritis (odds ratio, 0.37; 95% confidence interval, 0.15-0.89). Although not optimal treatment, administration of TMP-SMZ is effective against chlamydial infection. We speculate that the use of concomitant medications, such as TMP-SMZ, may be inadvertently preventing chlamydial infection in this population. Another finding was the presence of Trichomonas vaginalis in pharyngeal specimens of 3 men with histories of orogenital activity. This has not been previously reported and requires further study.
Bibliographical noteFunding Information:
Financial support: National Institutes of Health–Fogarty Center International Training and Research in Emerging Infectious Diseases grant and the charitable anonymous RG-ER fund.
Study site. The study was conducted at Dos de Mayo Hospital in Lima (population of 7 million), the capital city of Peru. Dos de Mayo Hospital is a large general and specialty university teaching hospital situated in downtown Lima. It is funded by the Ministry of Health and serves both the general and HIV-positive populations of lower to middle socioeconomic status who live in nearby districts and in the Lima metropolitan area. There are ∼400 annual admissions for HIV-related complications, most commonly diarrhea and tuberculosis. Patients are admitted to a 20-bed HIV ward or, if they do not require admission, are seen in consultation at an outpatient clinic adjacent to the ward. During the study period, with rare exceptions, both the inpatient and outpatient facilities treated only HIV-infected patients (V.M.C., personal observations).
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