1394. Are Sexual Factors Related to MRSA Colonization among HIV-Infected Persons?
Session: Oral Abstract Session: Complications of HIV
Sunday, October 23, 2011: 8:15 AM
Room: 151AB
Background:  Methicillin-resistant Staphylococcus aureus (MRSA) has become a major public health threat, and HIV-infected persons are at heightened risk for developing MRSA infections.  Since colonization increases the risk of infection, we evaluated factors associated with colonization among HIV patients.

Methods: A cross-sectional study of HIV-infected adults was performed to evaluate factors, including sexual behaviors, associated with MRSA colonization.  Subjects were enrolled from four HIV clinics in various geographic areas of the U.S.  Swabs were collected at five body sites from each participant.  Associations between MRSA carriage and variables of interest were performed using logistic regression.

Results: 550 HIV-infected persons were enrolled with a median age of 42 years; 93% were male; 46% Caucasian and 35% African American.  The median CD4 count was 529 (IQR 404-704) cells/mm3, and 70% were receiving HAART. Twenty-one percent had a documented sexually transmitted infection (STI) in the year before enrollment (including 8% with syphilis), 20% reported having >2 sexual partners in the last 6 months, 50% reported always using a condom, and 8% reported public bath use.  Four percent of HIV patients were colonized with MRSA at one or more body sites.  In the multivariate model, STI in the last year (OR 4.2, p<0.01), history of a MRSA infection (OR 9.4, p<0.01), and African American versus Caucasian race (OR 3.5, p=0.01) were associated with MRSA colonization.  In separate multivariate models, syphilis in the last year (OR 9.3, p<0.01) and public bath use (OR 8.9, p<0.01) were also associated with MRSA carriage.

Conclusion:  MRSA colonization is associated with recent STIs, suggesting that MRSA may be transferred in the setting of sexual contact.  High-risk behaviors that place HIV-infected persons at risk for STIs may also increase the risk of MRSA transmission, signifying the potential dual benefit of safe sex practices.  

Subject Category: H. HIV/AIDS and other retroviruses

Nancy Crum-Cianflone, MD MPH1,2, Aladdin Shadyab, MPH2, Amy Weintrob, MD1, Duane Hospenthal, MD, PhD1, Tahaniyat Lalani, MD1, Gary Collins, MS1, Alona Mask1, Katrin Mende, PhD1, Stephanie Brodine, MD2 and Brian Agan, MD1, (1)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, (2)San Diego State University, San Diego, CA


N. Crum-Cianflone, None

A. Shadyab, None

A. Weintrob, None

D. Hospenthal, None

T. Lalani, None

G. Collins, None

A. Mask, None

K. Mende, None

S. Brodine, None

B. Agan, None

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