HIV infection among patients with sexually transmitted diseases in rural South Africa

A cross-sectional study of 360 patients presenting with sexually transmitted diseases (STDs) to a primary care clinic in KwaZulu/Natal, South Africa was done. Prevalence of HIV infection was 42.5%. HIV-infected patients were of similar age to uninfected patients (mean age 25.1 vs 26.1 years), but were less likely to be married (9.2% vs 18.8%; P = 0.02). HIV prevalence was highest among young women (47.9% among women aged 15-34 years compared with 33.1% among men of the same age; P = 0.03). History of a previous STD in the preceding 3 months was high (40.1% in HIV-infected patients). Similar proportions of the HIV-infected and HIV-uninfected had sought care for the previous illness at private practitioners (16.9%), and primary care clinics (50.0%), and traditional healers (14.6%) or had treated themselves (18.5%). Patients with an STD are at very high risk of HIV infection in this setting. Repeat STDs are frequent and opportunities exist to improve treatment seeking behaviour, to reduce the risk of recurrent STDs, and hence to reduce the incidence of HIV infection.