The prevalence of human immunodeficiency virus infection in patients with sexually transmitted diseases

Document Type : Original Article

Authors

1 Department of Infectious Diseases, School of Medicine; Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

2 Psoriasis Research Center; Department of Dermatology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

3 Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

4 Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

5 Department of Infectious Diseases, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

6 Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

Abstract

Background: Human immunodeficiency virus (HIV) transmission pattern in Iran has been changed from injection drug to sexual contact. Lack of accurate assessment of HIV in people with sexually transmitted diseases (STDs) in Iran prompted us to conduct this study to determine the frequency of HIV infection in these patients.Materials and Methods: In this cross-sectional study which conducted in 2016–2017, overall, 190 patients with STDs referring to two hospitals of Hamadan were enrolled in the study. All of the patients were examined for HIV in the first visit by rapid test and then 1 and 4 months later by the 4th generation ELISA. A questionnaire including demographic data, clinical manifestations, and high-risk behaviors was completed for all of the referring people. The collected data were analyzed using appropriate statistical tests. Results: Of 190 patients, 126 (66.3%) were female with a mean age of 34.1 ± 10.1 years and 64 (33.7%) were male with a mean age of 30.8 ± 7.8 years. One hundred twenty-eight (67.4%) got married, 73 (38.4%) and 76 (40%) had a diploma and postgraduate education, respectively, 32 (16.8%) mentioned the history of unsafe sex, and 23 (12.1%) had used condoms continuously during sexual contacts. The most common STDs were reported genital warts, 107 patients (56.3%), vaginal discharge (28, 14.7%), and genital ulcer (33, 17.4%). Two (1%) patients were positive for HIV at the first visit. Conclusion: Patients with STDs should be considered as an important source of HIV transmission, so clinicians should pay more attention to screening these patients for HIV infection.

Keywords

1.
Nasirian M, Kianersi S, Hoseini SG, Kassaian N, Yaran M, Shoaei P, et al. Prevalence of sexually transmitted infections and their risk factors among female sex workers in Isfahan, Iran: A cross-sectional study. J Int Assoc Provid AIDS Care 2017;16:608-14.  Back to cited text no. 1
    
2.
Latifi A, Merghati-Khoei E, Shojaeizadeh D, Nedjat S, Mehri A, Garmaroudi G. Theory-based interventions in STIs/HIV Prevention: A systematic review of the literature in Iran. Med J Islam Repub Iran 2017;31:131.  Back to cited text no. 2
    
3.
Goya MM, Tayeri K, Kazeroni PA, Farhoudi B, Sori T, Emadi H, et al. Country Guide for the Care and Treatment of Sexually Transmitted Infections. 1st ed. Tehran: Andishmand; 2015. p. 13-173.  Back to cited text no. 3
    
4.
Brownstein PS, Gillespie SE, Leong T, Chahroudi A, Chakraborty R, Camacho-Gonzalez AF. The association of uncontrolled HIV infection and other sexually transmitted infections in metropolitan Atlanta youth. Pediatr Infect Dis J 2015;34:e119-24.  Back to cited text no. 4
    
5.
Nasirian M, Baneshi MR, Kamali K, Haghdoost AA. Estimation of prevalence and incidence of sexually transmitted infections in Iran; A model-based approach. J Res Health Sci 2015;15:168-74.  Back to cited text no. 5
    
6.
Unaids.org. (2019). Homepage. [online] Available at: http://www.unaids.org/en [Accessed 19 Jan. 2019].  Back to cited text no. 6
    
7.
Shokoohi M, Noori A, Karamouzian M, Sharifi H, Khajehkazemi R, Fahimfar N, et al. Remaining gap in HIV testing uptake among female sex workers in Iran. AIDS Behav 2017;21:2401-11.  Back to cited text no. 7
    
8.
Lotfi R, Ramezani Tehrani F, Salehifar D, Dworkin SL. Predictors of Condom Use Among Iranian Women at Risk of HIV. Arch Sex Behav 2016;45:429-37.  Back to cited text no. 8
    
9.
Rostami F, Shokoohi M, Bamimore MA, Nasirian M, Asadi-Aliabadi M, Haghdoost A. Prevalence of sexually transmitted infections based on syndromic approach and associated factors among Iranian women. Iran J Health Sci 2017;5:1-12.  Back to cited text no. 9
    
10.
Mozafari M, Mayer KH. Social change and HIV in Iran: Reaching hidden populations. Lancet HIV 2017;4:e282-3.  Back to cited text no. 10
    
11.
Guidelines for the Management of Sexually Transmitted Infections 2004. 2. Treatment of STI-Associated Syndromes: 2.2. Genital Ulcer; 2019. Available from: http://apps.who.int/medicinedocs/en/d/Jh2942e/3.2.HTML. [Last accessed on 2019 Jan 19].  Back to cited text no. 11
    
12.
Themba G Ginindza, Cristina D Stefan, Joyce M Tsoka-Gwegweni, Xolisile Dlamini, Pauline E Jolly, Elisabete Weiderpass, et al. Prevalence and risk factors associated with sexually transmitted infections (STIs) among women of reproductive age in Swaziland. Infect Agent Cancer. 2017; 12: 29. doi: 10.1186/s13027-017-0140-y  Back to cited text no. 12
    
13.
Osinde MO, Kakaire O, Kaye DK. Sexually transmitted infections in HIV-infected patients in Kabale Hospital, Uganda. J Infect Dev Ctries 2012;6:276-82.  Back to cited text no. 13
    
14.
Shobeiri F, Nazari M. A prospective study of genital infections in Hamedan, Iran. Southeast Asian J Trop Med Public Health 2006;37 Suppl 3:174-7.  Back to cited text no. 14
    
15.
Chen YC, Liu HY, Li CY, Lee NY, Li CW, Ko WC, et al. The rising trend of sexually transmitted infections among HIV-infected persons: A population-based cohort study in Taiwan, 2000 through 2010. J Acquir Immune Defic Syndr 2015;68:432-8.  Back to cited text no. 15
    
16.
Heiligenberg M, Rijnders B, Schim van der Loeff MF, de Vries HJ, van der Meijden WI, Geerlings SE, et al. High prevalence of sexually transmitted infections in HIV-infected men during routine outpatient visits in the Netherlands. Sex Transm Dis 2012;39:8-15.  Back to cited text no. 16
    
17.
Castro JG, Alcaide ML. High rates of STIs in HIV-infected patients attending an STI clinic. South Med J 2016;109:1-4.  Back to cited text no. 17
    
18.
Stoliaroff-Pépin A, Speck RF, Vernazza P. Prevention of HIV and other sexually transmitted infections (STI). Ther Umsch 2014;71:515-23.  Back to cited text no. 18
    
19.
Sharifi H, Mirzazadeh A, Shokoohi M, Karamouzian M, Khajehkazemi R, Navadeh S, et al. Estimation of HIV incidence and its trend in three key populations in Iran. PLoS One 2018;13:e0207681.  Back to cited text no. 19
    
20.
National AIDS Committee Secretariat, Ministry of Health and Medical Education. On Monitoring of the United Nations General Assembly Special Session on HIV and AIDS. Islamic Republic of Iran, AIDS Progress Report; 2015.  Back to cited text no. 20
    
21.
Eaton EF, Hudak K, Muzny CA. Budgetary impact of compliance with STI screening guidelines in persons living with HIV. J Acquir Immune Defic Syndr 2017;74:303-8.  Back to cited text no. 21
    
22.
Reda S, Gonçalves FA, Mazepa MM, De Carvalho NS. Women infected with HIV and the impact of associated sexually transmitted infections. Int J Gynaecol Obstet 2018;142:143-7.  Back to cited text no. 22
    
23.
World Health Organization. HIV/AIDS. World Health Organization; 2019. Available from: https://www.who.int/gho/hiv/en/. [Last accessed on 2019 Jan 19].  Back to cited text no. 23
    
24.
Shokoohi M, Karamouzian M, Khajekazemi R, Osooli M, Sharifi H, Haghdoost AA, et al. Correlates of HIV testing among female sex workers in Iran: Findings of a national bio-behavioural surveillance survey. PLoS One 2016;11:e0147587.  Back to cited text no. 24
    
25.
Moayedi-Nia S, Bayat Jozani Z, Esmaeeli Djavid G, Entekhabi F, Bayanolhagh S, Saatian M, et al. HIV, HCV, HBV, HSV, and syphilis prevalence among female sex workers in Tehran, Iran, by using respondent-driven sampling. AIDS Care 2016;28:487-90.  Back to cited text no. 25
    
26.
Pourmarzi D, Sharami SH. Midwives' educational needs and knowledge about sexually transmittable infections in the Islamic Republic of Iran. East Mediterr Health J 2017;23:611-8.  Back to cited text no. 26
    
27.
Milani HS, Azarghashb E. Knowledge and attitudes of female students who live in Tehran dormitories, towards STDs and sexual relationships. Iran J Clin Infect Dis 2011;6:35-40.  Back to cited text no. 27