Prevalence of Sexually Transmitted Co-infection in People Living with HIV/AIDS: Systematic Review with Implications for Using HIV Treatments for Prevention
Kalichman, S., Pellowski, J., and Turner, C. Sexually Transmitted Infections (April 2011), 87(3): 183–190.
The review examined the role that sexually transmitted infections (STIs) play in people living with HIV (PLHIV) and how the co-infections of STIs and HIV affect the prevention potential of antiretroviral therapy (ART) in limiting HIV transmission rates. The 37 eligible studies, published from 2000 to 2010, reported on STIs in PLHIV, specifically those showing HIV shedding in the genital tract (syphilis, chancroid, and gonorrhea). Mean overall prevalence of STI co-infection was 16.3 percent. The most common STIs co-infections were syphilis, gonorrhea, chlamydia, and trichomoniasis. The highest prevalence of STI/HIV co-infections were in people newly diagnosed with HIV, but STI co-infections occur throughout the course of HIV infection. People taking ART also were diagnosed with STI co-infections to a high degree; there was no significant difference in the prevalence of co-infections between PLHIV who were or were not on ART. The authors discussed the limitations of forecast data on the overall effect of ART on reducing transmission rates in HIV epidemics. Forecasting models often do not include the effect of STI co-infections, which would reduce the success of those results. They concluded that STI co-infections should be included in future models and forecasts that examine ART as a prevention strategy.