STI co-infections at HIV diagnosis in france Florence LOT, Françoise Cazein, Josiane Pillonel, Ndeindo Ndeikoundam “No conflict of interest to declare”

Objectives and methods To analyse the frequency of STI in people newly diagnosed for HIV between 2012 and 2016 In the mandatory HIV surveillance system, 4 bacterial STI syphilis, gonorrhoea, genital chlamydial infection and rectal lymphogranuloma venereum (LGV) reported in adults (≥15 years old) since 2012 (as yes / no / unknown) if concurrently diagnosed at the time of HIV diagnosis or diagnosed in the previous 12 months before HIV diagnosis Defined as «STI/HIV co-infections» Analysis by transmission group (overall / for each STI) and trends

RESULTS (1) Information on STI diagnoses available for 12,047 new HIV diagnoses in adults during the period 2012-2016 (52% of all new HIV diagnoses) STI/HIV co-infections were globally 14.6% (1,764/12,047) of HIV diagnoses but more frequent in men having sex with men (MSM) Frequency of STI/HIV co-infections in adults by HIV transmission group and sex, 2012-2016

RESULTS (2) STI/HIV co-infections have significantly increased overtime, from 12.6% in 2012 to 18.3% in 2016 (p<10-4) By transmission group, this increase was significant only in MSM, from 22.1% to 31.9% (p<10-4) Frequency of STI/HIV co-infections in adults by HIV transmission group and year of HIV diagnosis, 2012-2016

RESULTS (3) Among the 4 bacterial STI reported, syphilis was the most frequent, particularly in MSM Heterosexual men were more often co-infected with syphilis and gonorrhoea than heterosexual women, who were more frequently co-infected with chlamydia Rectal LGV was diagnosed only in MSM Frequency of STI/HIV co-infections in adults by bacterial STI and HIV transmission group, 2012-2016 MSM Heterosexual men Heterosexual women IDU N= 5,216 N=2,614 N=3,131 N=134 % Syphilis 20.2 6.0 1.3 5.2 Gonorrhoea 4.5 0.9 0.3 0.0 Genital chlamydial infection 3.5 1.7 2.2 Rectal LGV 0.5

Thanks to all biologists and clinicians reporting HIV diagnoses ! conclusion STI/HIV co-infections have increased overtime and affect almost one third (32%) of MSM newly diagnosed with HIV in 2016 (syphilis+++) These results underline the importance of offering an HIV test to patients presenting with a STI and conversely, as recommended in France In a context of STI increase in MSM and combined prevention for HIV, STI repeated screening is particularly important to treat rapidly patients and partners Thanks to all biologists and clinicians reporting HIV diagnoses !