HIV seropositivity among patients with sexually transmitted diseases

Introduction

Persons with sexually transmitted diseases (STD) form the high risk group for the transmission of HIV India has a high incidence of STDs i.e. 5% (40 million) of new cases a year.[1] There is a strong association between the occurrence of HIV infections and the presence of other STDs.[2]

Severity of manifestations and infectivity of STDs in HIV infected patients is more because of some degree of immunodeficiency. HIV positive individual having other STDs are more liekly to transmit HIV to others by shedding or releasing HIV cells in both ulcerative and inflammatory genital secretions.′ Ulcerative as well as some non-ulcerative STDs (such as gonorrhoea and chlamydial infections) facilitate the transmission of HIV. A significant increase in the prevalence of HIV among male patients suffering from various STDs has been observed.[4]

The susceptibility of non-infected partners to HIV also increases with these STDs.s This study was undertaken to ascertain the HIV infectivity of patients presenting with STDs in Punjab and also highlights the trends of HIV infection over the past few years.

Materials and Methods

A total of 2013 patients suffering from various STDs were tested from January 1998 to December 2001 in VCTC of Department of Microbiology, Govt. Medical College, Amritsar. Their risk behaviour, sexual partners, past and current STD, socio-economic and demographic details were recorded. The samples were collected and preserved with all the standard precautions and tested by ELISA with commercial test kits (supplied by NACO). Reactive samples were confirmed with two other ERS (test) of different principle and/or antigen.

Results

Out of 2013 patients, screened, sixty-one (3.03%) were found to be positive for HIV. The annual HIV antibody prevalence rate is shown in [Table - 1]. Among the positive patients 44 were males and 17 were females [Table - 2]. The maximum number of patients (22) were between the age group of 30-39 years [Table - 2].

Discussion

Out of 2013 patients screened sixty-one (3.03%) were found to be HIV positive. The incidence is almost the same as reported in a study from Tanzania[6] (3.8%).

The annual HIV antibody prevalence rate [Table - 1] is also consistent with the study of other workers who have noted a rise in the prevalence of HIV among the STD attenders.[7]

A significant finding in the present study was a consistent rise in the percentage positivity in females from 14.3% in 1998 to 38.09% in 2001 which is also reported in a study from Aurangabad.[8] 27.9% (17) of the positive persons were below the age of 25 years whereas in other study[9] this incidence was 78%, which might be because of the socio-demographic vulnerability of the people of that area.

Thus screening for HIV antibody prevalence in STD clinic offenders is likely to help in understanding the reality of spread of HIV infections. Many other parts of the developing world, including Southern Asia where the HIV epidemic is now spreading rapidly, have high rates of STDs. As both HIV and STDs are closely interlinked early diagnosis, treatment and control of STD offers a rational approach to the control of HIV.

The present study highlights the need for modest interventions - educational interventior aimed at modifying risk behaviour at school leve along with moral and health education to preven HIV infection in younger age group.