Rates of Sexually Transmitted Infection Diagnoses Among US Youth With Perinatally and Nonperinatally Acquired HIV

• Published in: Sexually transmitted diseases Vol. 49; no. 3; pp. 223 - 230
• Main Authors: Neilan, Anne M., DeMonte, Justin B., Foote, Julia H. A., Karalius, Brad, Patel, Kunjal, Kapogiannis, Bill G., Rudy, Bret J., Huszti, Heather, Fernandez, M. Isabel, Hudgens, Michael G., Ciaranello, Andrea L.
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-03-2022; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome; Acquisition; Adolescent; Adolescents; Adult; African Americans; AIDS; Antiretroviral agents; Antiretroviral therapy; Bacteria; CD4 antigen; CD4 Lymphocyte Count; Diagnosis; Drug therapy; Female; Females; HIV; HIV Infections - diagnosis; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Immune response; Infant, Newborn; Infections; Male; Medical diagnosis; Original Studies; Perinatal; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - epidemiology; STD; United States - epidemiology; Young Adult; Youth; United States; United States > US
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/OLQ.0000000000001578

Of new sexually transmitted infections (STIs) in the United States, 50% occur among youth aged 15 to 24 years. Previous studies among youth with HIV (YHIV) do not distinguish STI trends among individuals with perinatally (YPHIV) and nonperinatally (YNPHIV) acquired HIV.
Among 3 Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) studies conducted between 2009 and 2015, we estimated incident diagnoses of trichomonal, bacterial, viral, and overall STIs stratified by sex assigned at birth, mode of HIV acquisition (perinatal [YPHIV] and nonperinatal [YNPHIV]), age (13-17 and 18-24 years), CD4 count (<200, 200-499, and ≥500/μL), and HIV viral load (VL) (<400 and ≥400 copies/mL).
Among 3131 YHIV, across the 3 studies, mean (SD) age was 20.6 (2.6) years, 888 (28%) were female, 2498 (80%) had nonperinatal HIV acquisition recorded, and 2298 (73%) were African American/Black. Mean follow-up was 0.9 (0.3) years. Compared with YPHIV, YNPHIV spent less person-time with VL <400 copies/mL (47% vs. 53%) and more time off antiretroviral therapy (49% vs. 15%), and had higher overall STI rates (males, 65.9 vs. 8.5/100 person-years [PY]; females, 54.7 vs. 17.2/100 PY). Among YPHIV, bacterial STIs were higher during person-time spent with VL ≥400 vs. <400 copies/mL (male YPHIV, 10.9 vs. 0.6/100 PY; female YPHIV, 11.2 vs. 2.9/100 PY); no difference was observed among YNPHIV, which may be due to concurrent acquisition of HIV and other STIs and limited follow-up.
Compared with YPHIV, YNPHIV spent less time on antiretroviral therapy and virologically suppressed; YNPHIV also had higher STI diagnosis rates. Very high STI diagnosis rates among YHIV, including among those without virologic suppression, highlight the importance of youth-focused efforts to support durable virologic suppression and identify and treat STIs.