Resum

Objectives: In Spain, current data shown that homo/bisexual men are more severely affected by sexually transmitted diseases (STDs) than other populations groups. Taking into account that the presence of STDs increases the risk of human immunodeficiency virus (HIV) transmission, we have analysed the prevalence of HIV in homo/bisexual men diagnosed of Neisseria gonorrhoeae, Chlamydia trachomatis or syphilis, between 2009 and 2012 in a STD clinic in Madrid. Methods: We analysed 21297 samples of urethral, pharyngeal and rectal exudates by molecular methods (Chlamydia trachomatis), gram staining and/or cultures incubated aerobically (CO2) under 37ºC (Neisseria gonorrhoeae) and serological methods (syphilis). Providing that any STD was detected, a HIV serological test was also performed. Results: N. gonorrhoeae was detected in 1094 cases, C. trachomatis in 1033 and early syphilis in 908 (287 primary, 311 secondary and 291 early latent). Prevalence of HIV infection among the patients with gonococcal infection was 35.1%. According to localisation of gonococci, HIV infection was also identified in 56.5, 21.5 and 19.9% of proctitis, pharyngitis and urethritis cases, respectively. Among the 989 patients infected by C. trachomatis, HIV coinfection was found in 515 (52.1%). By localisation, HIV prevalence was 67.7, 38.9 and 18.1% for proctitis, pharyngitis and urethritis, respectively. Early syphilis was diagnosed in 908 patients, 47.5% of them coinfected with HIV. They represented 43.9, 46.9 and 54.6% of the primary, secondary and early latent syphilis cases, respectively. Conclusions: A very high HIV prevalence was found in homo/bisexual men diagnosed of early syphilis and proctitis by C. trachomatis o N. gonorrhoeae. Early diagnosis and prompt treatment of STDs can reduce the risk of HIV transmission. It is highly recommended to carry out always a HIV serology in homo/bisexual men with other STDs and also a screening for other STDs in HIV-positive patients according to their risk practices, including genital and extragenital exudates.