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Objectives  The aims of this study were to identify temporal trends in the incidence of sexually transmitted diseases ( STDs ) in a cohort of  HIV ‐infected people and to evaluate factors associated with the risk of a new  STD  diagnosis.    Methods  All  HIV ‐infected patients in the  I cona  F oundation Study cohort enrolled after 1998 were included in this study.  STD  incidence rates ( IRs ) were calculated and stratified by calendar period. Predictors of  STDs  were identified using a  P oisson regression model with sandwich estimates for standard errors.    Results  Data for 9168 participants were analysed [median age 37.3 (range 18–81) years; 74% male; 30% men who have sex with men ( MSM )]. Over 46 736 person‐years of follow‐up ( PYFU ), 996 episodes of  STDs  were observed [crude  IR  21.3/1000  PYFU ; 95% confidence interval ( CI ) 20.0–22.6/1000  PYFU ]. In multivariable  P oisson regression analysis,  MSM  [rate ratio ( RR ) 3.03; 95%  CI  2.52–3.64 versus heterosexuals], calendar period ( RR  1.67; 95%  CI  1.42–1.97 for 2008–2012 versus 1998–2002),  HIV RNA  > 50  HIV ‐1  RNA  copies/mL ( RR  1.44; 95%  CI  1.19–1.74 versus  HIV RNA  ≤ 50 copies/mL) and a current CD4 count < 100 cells/μL ( RR  4.66; 95%  CI  3.69–5.89;  P  < 0.001 versus CD4 count > 500 cells/μL) were associated with an increased risk of  STDs . In contrast, older age ( RR  0.82 per 10 years older; 95%  CI  0.77–0.89) and being currently on  ART  ( RR  0.38; 95%  CI  0.33–0.45) compared with being  ART ‐naïve or on a treatment interruption were associated with a lower risk of developing  STDs .    Conclusions  An increase in the incidence of  STDs  was observed in more recent years. Interventions to prevent  STDs  and potential spread of  HIV  should target the younger population,  MSM  and people currently not receiving  ART .

hiv medicine

Incidence and factors associated with the risk of sexually transmitted diseases in  HIV ‐infected people seen for care in  I taly: data from the  I cona  F oundation cohort