AEGiS-15IAC: High HIV and STI prevalence in young men who inject drugs and have sex with men in San Francisco, the Saint UFO study.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

High HIV and STI prevalence in young men who inject drugs and have sex with men in San Francisco, the Saint UFO study.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThOrC1368)

Lum PJ, Cohan D, Davidson P, Wirengard Y, Klausner J
University of California, San Francisco, United States

BACKGROUND: HIV transmission is primarily sexual in MSM-IDU, and concurrent STIs can increase HIV transmission. Younger MSM-IDU may be at higher risk of HIV infection, but the epidemiological relationship between HIV and other STIs in this population has not been described.

METHODS: An ongoing cohort study of 200 young, street-recruited MSM-IDU collects behavioral and biological data at baseline and 6 months to evaluate a combined HIV/STD counseling and testing intervention. Eligible subjects are males age 29 and under, who inject drugs and report sex with a male in the prior 6 months. Blood is tested for HIV, herpes simplex 2 (HSV-2), and syphilis. Urine and pharyngeal and rectal swabs are tested for gonorrhea (GC) and chlamydia (CT). Subjects return in one week for test results, counseling, treatment, and referrals.

RESULTS: Among 66 baseline subjects to date, median age was 25 years [IQR 23-26], 68% were white, and 70% were homeless. Subjects injected drugs frequently (med ian 51 injections [IQR 12-80] in last month), and 85% used methamphetamines. Many (59%) received cash for sex in the prior 6 months, and 39% reported >100 lifetime sexual partners. 61 agreed to HIV testing; 6 (10%) declined rectal swabs. HIV prevalence was 26%; HSV-2 28%; syphilis 0%; pharyngeal GC 15%; rectal GC 4%; urethral GC 2%; pharyngeal CT 2%; rectal CT 5%; and urethral CT 0%. Co-infection was common with 38% testing positive for more than one infection. Compared to HIV-negatives (see table), HIV-positive subjects were more likely to test positive for another STD and to test positive for HSV-2 or CT. [table: see text] Conclusion Young MSM-IDU in San Francisco are a core high-risk group. HIV prevalence is higher than expected for this age, and concurrent STDs, especially HSV-2, are common. Because HIV and other STDs share transmission routes, early detection and control of STDs, including HSV-2, may be an effective strategy for preventing transmission of HIV in young MSM-IDU.

Keywords: AEGIS, Prevalence, HIV, Acquired Immunodeficiency Syndrome, HIV Seropositivity, HIV Infections, Coitus, Substance Abuse, Intravenous, Sex, Sexual Partners, HIV Seronegativity, Syphilis, Herpesvirus 2, Human, Safe Sex, San Francisco, Cohort Studies, Humans, Male, epidemiology, immunology

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ThOrC1368