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showed evidence?
Sep 18, 2004

"There is no reason why syphilis and HIV cannot be transmitted the same time and there are data from sexually transmitted disease (STD) clinics in Southern Africa showing that about 2% of patients with other STDs had evidence of acute HIV infection."

You guys put so much emphasis on the idea that an HIV diagnosis is a black and white issue - you're either HIV positive or HIV negative. And sometimes, even a positive PCR during acute infection can justify an HIV diagnosis. But to say there is some "evidence" of HIV infection in a study in Africa is to say that an HIV diagnosis can be determined based on factors other than a positive antibody test, or a substantial viral load by PCR.

What was this "evidence" that you speak of?

Response from Dr. Pierone

I did not mean to imply that HIV was diagnosed other than by definitive means. Even though the study was done in Africa the investigators had access to up to date testing technology.

This study was done a few years ago in Malawi. The study team did HIV blood testing for both HIV antibody and HIV RNA in over 1361 men that presented to a clinic for treatment of sexually transmitted diseases. Of these men, 553 (40.6%) were already infected with HIV, no big surprise since Malawi has one of the highest HIV rates in the world. They also found that 28 of these men (2.1%) had positive RNA, but negative antibodies, indicating that they had primary HIV infection. The point is that it is certainly possible, and perhaps more likely, for some people to acquire more than one sexually transmitted disease at one time. This is as true in New Orleans as it is in Kinsasha.



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