Behavioral changes associated with testing HIV-positive among sexually transmitted infection clinic patients in Cape Town, South Africa

Objectives. We sought to examine behavioral risks and behavior changes associated with testing HIV-positive among sexually transmitted infection (STI) patients, in order to inform HIV- and STI-prevention interventions. Methods. We performed a cohort study of 29 STI patients who seroconverted from HIV-negative to HIV-positive during 1 year of observation and 77 STI patients who persistently tested HIV-negative. Computerized behavioral interviews were collected at baseline and at 1 year, and STI clinic charts were abstracted over the same 1-year period. Results. The STI patients who reported genital bleeding during sexual activity at baseline were significantly more likely to test HIV-positive. Reductions in number of sexual partners and rates of unprotected intercourse occurred for all STI clinic patients regardless of whether they tested HIV-positive. Conclusions. Although risk reductions occurred, 5% of HIV-negative STI clinic patients subsequently tested HIV-positive over 1 year. Behavioral risk reduction interventions are urgently needed for male and female STI clinic patients.