(P61) SEXUALLY TRANSMITTED INFECTIONS AMONG PEOPLE WHO INJECT DRUGS WITH HIV IN WEST VIRGINIA

Background:
In West Virginia, the majority of new HIV cases are now associated with people who inject drugs (PWID) as opposed to men who have sex with men (MSM).  Historically, co-infection of other sexually transmitted infections (STIs) was considered common among newly diagnosed HIV individuals reporting sexual exposures as their primary risk.  Due to the shift in risk factors, investigators reviewed STI co-infections among PWID from two large HIV clusters in West Virginia.

Methods:
HIV cases reported in the Enhanced HIV/AIDS Reporting System (eHARS) among two ongoing clusters were compared to STI surveillance data in the West Virginia Electronic Disease Surveillance System (WVEDSS).  All Cabell County and Kanawha County HIV cluster cases (reported in eHARS as of 7/5/23) were reviewed to determine STI history.  Syphilis, chlamydia, and gonorrhea diagnoses occurring before, concurrently (defined as a positive STI lab result within 30 days of HIV diagnosis), or after the HIV diagnosis were analyzed.

Results:
Among 368 total HIV cluster cases, 43 (11.68%) had a reported syphilis infection, 45 (12.23%) had a reported chlamydia infection, and 48 (13.04%) had a reported gonorrhea infection.  Six cluster cases were not found in WVEDSS.  There were five HIV cluster cases that had multiple syphilis infections.  There were no chlamydia re-infections discovered, but there were two that had multiple gonorrhea re-infections.

Conclusion:
Gonorrhea was the most common STI infection prior to HIV diagnosis.  Syphilis infections were more likely to be reported after HIV diagnosis, which may be due to the regular screening recommendations for people living with HIV (PLWH).  Up to 17.5% of HIV cluster cases had a concurrent STI diagnosis, suggesting that sexual exposure was still a risk factor.  Findings indicate the importance of STI testing in PWID and a need for a syndemic approach to address interrelated epidemics.