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Epidemiology
ORIGINAL ARTICLE
High burden of STIs among HIV-infected adults prior to initiation of ART in South Africa: a retrospective cohort study Mark N Lurie,1 Kipruto Kirwa,1,2 Johann Daniels,3 Marcel Berteler,3 Seth C Kalichman,4 Catherine Mathews5 ▸ Additional material is published online only. To view please visit the journal online (http://dx.doi.org/10.1136/ sextrans-2013-051446). 1
Brown University School of Public Health, Providence, Rhode Island, USA 2 Department of Epidemiology and Nutrition, Moi University School of Public Health, Eldoret, Kenya 3 Health Information and Technology, City Health, Cape Town, South Africa 4 Department of Psychology, University of Connecticut, Storrs, Connecticut, USA 5 Health Systems Research Unit, South African Medical Research Council; and the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa Correspondence to Dr Mark N Lurie, Brown University School of Public Health, Providence, RI, 08912, USA, [email protected] Received 14 November 2013 Revised 21 April 2014 Accepted 28 April 2014 Published Online First 16 May 2014
ABSTRACT Objectives To assess the burden of sexually transmitted infections (STIs) among HIV-positive South Africans in the period prior to antiretroviral therapy (ART) initiation compared with the period once on ART. Methods We linked the clinic records of 1465 patients currently on ART to the electronic database which records all visits to city clinics. We used a mixed effects Poisson model to assess the relative rates of occurrence of treatment seeking for an STI in the periods prior to initiation of ART and while on ART. Results We accumulated 4214 person-years of followup, divided nearly equally between the pre-ART and onART periods. The rate of treatment seeking for new STIs was 5.50 (95% CI 5.43 to 5.78) per 100 person-years, and individuals had on average a sevenfold higher rate of seeking treatment for STIs in the period prior to initiating ART (9.57 per 100 person-years) compared with the period once on ART (5.5 per 100 person-years) (adjusted rate ratio (RR) 7.01, 95% CI 4.64 to 10.59). Being male (RR 1.73, 95% CI 1.18 to 2.55) or younger (age
Epidemiology
ORIGINAL ARTICLE
High burden of STIs among HIV-infected adults prior to initiation of ART in South Africa: a retrospective cohort study Mark N Lurie,1 Kipruto Kirwa,1,2 Johann Daniels,3 Marcel Berteler,3 Seth C Kalichman,4 Catherine Mathews5 ▸ Additional material is published online only. To view please visit the journal online (http://dx.doi.org/10.1136/ sextrans-2013-051446). 1
Brown University School of Public Health, Providence, Rhode Island, USA 2 Department of Epidemiology and Nutrition, Moi University School of Public Health, Eldoret, Kenya 3 Health Information and Technology, City Health, Cape Town, South Africa 4 Department of Psychology, University of Connecticut, Storrs, Connecticut, USA 5 Health Systems Research Unit, South African Medical Research Council; and the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa Correspondence to Dr Mark N Lurie, Brown University School of Public Health, Providence, RI, 08912, USA, [email protected] Received 14 November 2013 Revised 21 April 2014 Accepted 28 April 2014 Published Online First 16 May 2014
ABSTRACT Objectives To assess the burden of sexually transmitted infections (STIs) among HIV-positive South Africans in the period prior to antiretroviral therapy (ART) initiation compared with the period once on ART. Methods We linked the clinic records of 1465 patients currently on ART to the electronic database which records all visits to city clinics. We used a mixed effects Poisson model to assess the relative rates of occurrence of treatment seeking for an STI in the periods prior to initiation of ART and while on ART. Results We accumulated 4214 person-years of followup, divided nearly equally between the pre-ART and onART periods. The rate of treatment seeking for new STIs was 5.50 (95% CI 5.43 to 5.78) per 100 person-years, and individuals had on average a sevenfold higher rate of seeking treatment for STIs in the period prior to initiating ART (9.57 per 100 person-years) compared with the period once on ART (5.5 per 100 person-years) (adjusted rate ratio (RR) 7.01, 95% CI 4.64 to 10.59). Being male (RR 1.73, 95% CI 1.18 to 2.55) or younger (age
