Date of Award


Document Type

Campus Access Dissertation


Epidemiology and Biostatistics



First Advisor

Anwar T Merchant


Adherence to the Sexually Transmitted Diseases (STD) Screening Guidelines and the provision of risk reduction counseling for HIV-positive individuals who are engaged in care may help to decrease STDs as one of the potentiators of the HIV epidemic. STD co-morbidity among HIV-positive individuals can drastically increase the transmissibility of HIV and other STDs to uninfected individuals. STD acquisition in HIV-positive individuals indicates continued high risk sexual behavior, and HIV- positive individuals who have suboptimal medication adherence and concurrent STDs have the potential for transmitting resistant strains of HIV to others. Because of these factors, researchers are exploring the relationship between HIV-positive individuals and new STD acquisition and its role with HIV care engagement. This retrospective cohort study of 6,965 HIV-positive males in SC ¡Ý 13 years of age linked HIV case reports with STD surveillance, clinical care, and laboratory data. The objectives of this study were to evaluate the risk of new reportable STD acquisition in HIV-positive males in SC by race and risk behavior, to evaluate the joint risk of new reportable STD acquisition in HIV-positive males in SC by race/ethnicity and risk behavior and determine its relationship with HIV care engagement, and to describe the methodological challenges investigators met when assessing new STD acquisition in this population.