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ABSTRACT
Serumsamplesfrom750patientsattendingtheSTD
clinicwithvariousclinicalsignsandsymptomswere
screenedforHIVantibodybyELISA.Thesamples
werealsoscreenedforsyphilisbyVDRLtest.30(4
percent)werefoundtobepositiveforHIVand
amongthem14weremalesand16werefemales
31(4.1percent)werefoundtobeVDRLpositive
andHIVseropositivitywasseenmostlyinpersons
presentingwiththesymptomslikeurethralor
cervicaldischargeandgenitalulcer.
KEYWORDS
HIVseropositivity,STDs
INTRODUCTION
Personswithsexuallytransmitteddiseases(STD)
formthehighriskgroupforthetransmissionofHIV.
IndiahasahighincidenceofSTDs,i.e.5percent
(40milion)ofnewcasesayear 1.Accumulating
evidencesuggeststhatconcurrentinfectionswith
othersexuallytransmitteddiseasesincreasetherisk
ofHIVtramsmission,sotherewillbegreater
prevalenceofHIVinfectionsinSTDclinic
attenders2,3.
SeverityofmanifestationsandinfectivityofSTDsin
HIVinfectedpatientsaremorebecauseofsome
degreeofimmunodeficiency.HIVpositiveindividual
havingotherSTDsaremorelikelytotransmitHIV
toothersbysheddingorreleasingHIVcellsinboth
ulcerativeandinflammatorygenitalsecretions 4.
Ulcerativeaswellassomenon-ulcerativeSTDs
(suchasgonorrheaandchlamydialinfections)
facilitatethetransmissionofHIV.
Thesusceptibilityofnon—infectedpartnerstoHIV
increasewiththeseSTDs 5.Thisstudywas
undertakentoascertaintheHIVinfectivityofpatients
attendingtheSTDclinics.
MATERIAL&METHODS
Atotalof750bloodsampleswerecollectedovera
periodof3months(July2004–September2004)
fromthepatientsattendingtheSTDclinicattached
toM.K.C.G.MedicalCollege,Berhampur&STD
ClinicofKoraput&Rayagada.Theserumwere
collectedandpreservedwithallstandard
precautionsandscreenedforHIVantibodiesby
usingELISAkits(suppliedbyNACO).Reactive
samplesby methodwereagainconfirmed
byanotherELISAofdifferentprincipleand/orantigen
aspertheNACOguidelines.Theserumsampleswere
alsoscreenedforsyphilisbyVDRLtest.Complete
historyofthepatientsregardingage,sex,contact
history,occupationandotherriskfactorswerealso
collectedandtheresultswereanalyzed.
RESULT
Outof750patientsscreend,30(4percent)were
foundtobepositiveforHIV.Amongthemales,HIV
seropositivitywasconfirmedin14(5.1percent)
outof276casesandinfemales16(3.4percent)
outof474casesseeTable-1
SEROPOSITIVITYRESULTSFORHIV
TABLE:1
Number Tested    HIV Seropositivity%
Male 276 14(5.1)
Female 474 16(3.4)
Ttl 750 30(4)
HighestHIVseropositivity(11.1percent)wasfound
inmalesabove40yearsofagefollowedbythose
whoarebelow20years(8.3percent).Among
femalesalsohighestseropositvitiywasfoundabove
40years(4.2percent)followedbytheagegroup
31-40years(3.7percent)seeTable–2
SERO-PREVALENCEOFHIVINFECTIONSAMONGSTDCLINIC
ATTENDERSINSOUTHORISSA
PattnaikDipti*,PatnaikSatyadarshi**,SahuSusantKumar***
PadhySanghamitra*,DashMuktikesh**
*AssistantProfessor,MicrobiologyDepartment
**AssistantProfessor,Skin&VDDepartment
***Lecturer,MicrobiologyDepartment
*Lecturer,MicrobiologyDepartment
**M.K.C.G.MedicalCollege,Behrampura,Orissa
AddressforCorrespondence:
Dr.DiptiPattnaik,Assistant.Professor,DepartmentofMicrobiologyMKCGMedicalCollege,Qr.No.4R/B,
MedicalCampus,Behrampur,Orissa E-mail:drdiptipattnaik@yahoo.com
INDIANJSEXTRANSMDIS2005;VOL.26NO.1,14
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TABLE:2
AGE–WISEDISTRIBUTIONOF
HIVSEROPOSIVITIY:MALE
Below 21-30 yrs 31-40 yrs. Above TOTAL
20 yrs. of age ofage 40 yrs.
of age of
HIV 1/12 2/110 8/126 3/28 14/27
Antibody (8.3%) (1.8%) (6.3%) (11.1%) 6
 (5.1%)
TABLE:3
AGEWISEDISTRIBUTIONOFHIV
SEROPOSIVITIY:FEMALE
Below 21-30 yrs 31-40 yrs. Above TOTAL
20 yrs. of age ofage 40 yrs.
of age of
HIV 1/47 7/214 7/191 1/22 16/47
Antibody (2.1%) (3.3%) (3.7%) (4.2%) 4
 (3.4%)
Ofalltheserumsamplesscreened,VDRLwas
positivein31cases,HIVseropositivityin30cases
whereasbothVDRLandHIVpositivitywasseenin
only5cases.Mostofthecasesshowingpositivity
forbothVDRLandHIVweredetectedintheageof
morethan20yearsseeTable–3.
TABLE:4
SEROPOSIVITIYRESULTFORVDRL&HIV
Age HIVPositive VDRL Positive Both VDRL
& HIV
Positive
< 20 yrs (n=59) 2(3.4%) 2(3.4%) 1(1.7%)
> 20 yrs 28(4.05%) 29(4.1%) 4(0.5%)
(n=691)
Total (750) 30(4.0%) 31(4.1%) 5(0.6%)
MostoftheHIV+vecasescomingtotheSTDclinic
presentedwithurethralorcervicaldischarge(53.3
percent)orbygenitalulcer(36.6percent).But
VDRLwaspositivemostlyinpatientspresentingwith
genitalulcer(54.8percent)seeTable–4.
CorrelationofHIV&VDRLPosivitiyinPatients
withVarious
Tests Genital Urethral Genital Genital Ta
Ulcer or cervical ulcer warts
discharge discharge
HIV+ve 11 16 1 2 30
(36.6%) (53.3%) (3.3%) (6.6%) (4%)
VDRL+ve 17 11 1 2 31
(54.8%) (35.4%) (3.2%) (6.4%) (4.1%)
DISCUSSION
Outof750patientsscreened,30(4percent)were
foundtobeHIVpositive.Theincidenceisalmost
thesameasreportedinastudyfromTanzania6(3.8
percent).
Thepresentstudyshowedmalepredominacefor
HIVseropositivity(5.1percent)andmaximum
numberofpositivecases(15)wereseenamong
theagegroupof31-40yearswhichalsocorrelates
wellwiththatofthestudydonebyAggarwaletat7.
Thepointofvariationfromtheirstudyisthehighest
percentageofpositivecasesinbothmalesand
femalesintheageabove40yearswhichmaybe
explainedbythefactthatthenumberofcases
attendingtheSTDclinicabove40yearsofagein
ourstudywereveryless(40)accountingtohigher
perecentageforpositivity.
AmongmaleattendersmostpeoplehavingHIV
seroposivitiybelongedtolowermiddleclassand
thirteenpatientswereimmigrantsfromSuratand
Bombay.Amongfemaleattenders,mostofthem
havingseropositivitywerehousewives6/174(3.3
percent)andilliterate.However,sexworkersalso
showedseropositivityforHIV7/250(2.8percent).
Thehigherpercentageinhousewivesisprobably
duetothetransmissionfrommales(bothmigrated
fromSuratandBombayandnon-migratedones
havingcontactwiththesex-workers).
VDRLandHIVpositivityweredetectedmoreinthe
agegroupabove20years.In5(0.6percent)cases
bothVDRlandHIVtestwerepositiveoutofwhich4
casesweredetectedabove20yearsofage(0.5
percent).Thismaybeduetothesexuallyactive
personsbelongingtothisagegroupwhichcorrelates
wellwithstudyofAggarwaletal7.
DetectionofHIVantibodywashighestinpersons
attendingtheSTDclinicwithsymptomsofsexually
INDIANJSEXTRANSMDIS2005;VOL.26NO.1,15
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tranmsitteddiseaseslikeurethralorcervical
dischargeandgenitalulcer.Thisisprobablydueto
theulcerativeandnon-ulcerativelesionofSTD,
whichmightbefacilitatingthetransmissionofHIV8.
ThusscreeningforHIVantibodyprevalenceinSTD
clinicattendersislikelytohelpinunderstandingthe
realityofspreadofHIVinfection.Manyotherparts
ofthedevelopingworld,includingSouthernAsia
wheretheHIVepidemicisnowspreadingrapidly,
havehighratesofSTDs.AsbothHIVandSTDs
arecloselyinterlinked,earlydiagnosis,treatment
andcontrolofSTDoffersarationalapproachtothe
controlofHIV.
Thepresentstudyhighlightstheneedformodest
intervention–educationalinterventionaimedat
modifyingriskbehaviourofschoollevelalongwith
moralandhealtheducationtopreventHIVinfection
inyoungeragegroup.
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