Sexually transmitted infections case notification rates in the Kingdom of Saudi Arabia, 2005-2012.

INTRODUCTION: Sexually transmitted infections (STIs) are major public health concerns around the world. This study describes the epidemiology of reported STI cases from 2005 to 2012 in the Kingdom of Saudi Arabia. METHODOLOGY: The annual registry was the main source of data as reported by healthcare providers. Case definitions were based on positive human immunodeficiency virus (HIV) antibodies detectable by enzyme-linked immunosorbent assay (ELISA) and confirmed by western blot test for HIV cases. The definitions of other STIs were based on published Centers for Disease Control and Prevention (CDC) definitions. RESULTS: During the study period, 68,886 new cases were reported, with nongonococcal urethritis being the highest STI (25.4) per 100,000 population (25.4), followed by trichomoniasis (9.1), HIV (7), human papillomavirus (HPV) infection (2.9), and syphilis (1.3). The cases included nongonococcal urethritis (n = 35,613; 51.7%), trichomoniasis (n = 12,679; 18.4%), gonococcal urethritis (n = 3,006; 4.4%), syphilis (n = 1,769; 2.6%), HIV (n = 9,843; 14.3%), genital warts (n = 4,018; 5.8%), genital herpes (n = 1,508; 2.2%), and chancroid (n = 450; 0.7%). Saudi contribution to HIV cases increased from 28.9% in the preceding decade to 43.5% in the current study. CONCLUSIONS: Nongonococcal urethritis, trichomoniasis, and HIV were the most commonly reported STIs in the Kingdom of Saudi Arabia.

Knowledge and Attitudes about HIV/AIDS in Illegal Residents in the Kingdom of Saudi Arabia.

OBJECTIVES: To study the knowledge, attitudes, and practices with regard to human immunodeficiency virus infection / acquired immune deficiency syndrome (HIV/AIDS) in illegal residents, in the Kingdom of Saudi Arabia (KSA). MATERIALS AND METHODS: A questionnaire study was conducted among the illegal residents from four regions in Saudi Arabia: Jeddah, Makkah, Riyadh, and Jazan. RESULTS: The survey enrolled 5,000 participants, 79%male (39.6% from Jeddah; 20% from Riyadh; and 20% from Jazan), aged between 15 and 45 years. Of the total, 1288 (25.8%) had not heard about HIV/AIDS. Knowledge of HIV transmission was poor in 90% of the respondents. Of the total, 737 had read about HIV/AIDS materials and 649 participants had been previously tested for HIV. The majority of participants (85%) held a negative attitude toward people living with HIV/AIDS. Those who were knowledgeable about HIV/AIDS expressed more a positive attitude. One-fifth (968, majority were men; single 55%, married 45%) had engaged in non-marital sexual activity. The largest proportion of the individuals who had engaged in non-marital sex were single (54.9%) followed by the married ones (40.4%). Men cited pleasure as the main reason for such activity (84.6%), whereas women (73.4%) cited financial gain. Of the respondents, 53.9 and 32.1% believed that TV and schools were the best media through which information with regard to HIV/AIDS could be imparted. CONCLUSIONS: Knowledge of HIV/AIDS, its mode of transmission, and prevention measures was poor. Educational programs specifically targeted toward this group were required.

Antiretroviral therapy, CD4, viral load, and disease stage in HIV patients in Saudi Arabia: a 2001-2013 cross-sectional study.

INTRODUCTION: The incidence of HIV/AIDS is increasing worldwide and in the Middle East. In this study, we analyzed the use of antiretroviral therapy (ART), the patterns of CD4 and viral load (VL), and stage of presentation. METHODOLOGY: Laboratory variables, ART use, and CD4 count were obtained and analyzed retrospectively. RESULTS: A total of 997 cases from eight HIV/AIDS care providers were included. Of the total cases, 274 (28.3%) had a CD4 count of < 200 cells/mm(3), and 413 (42.3%) had a viral load of > 5 log10. Of the total cases, 50% were on highly active antiretroviral therapy (HAART), and the majority of cases were asymptomatic (70%). Of those patients on ART, 247 (39.5%) took tenofovir/emtricitabine combined with either efavirenz (147; 14.7%) or lopinavir/ritonavir (100; 10%), and 158 (15.8%) were on lamivudine and zidovudine with either efavirenz (32; 3.2%) or lopinavir/ritonavir (126; 12.6%). Other combinations were used in 70 (7%) patients. The mean (± standard deviation) of baseline CD4 and viral load were 401 cells/mm(3) (322 cells/mm(3)) and 4.6 log1010 (1.3 log10), respectively. At diagnosis, 72% of patients were asymptomatic; 50% had AIDS and 20% had CD4 count < 350. CONCLUSIONS: ART use was in line with international guidelines, but the number of patients receiving ART was lower than expected. Large proportions of cases presented late with AIDS at diagnosis or had CD4 < 350. Further data is needed to evaluate the medical care of patients with HIV/AIDS in the Kingdom of Saudi Arabia.

Prevalence and behavioral risk factors for STIs/HIV among attendees of the Ministry of Health hospitals in Saudi Arabia.

INTRODUCTION: Sexually transmitted infections (STI) are a major public health, social, and economic problem leading to morbidity, mortality, and stigma. This study was conducted to determine the prevalence of STIs, investigate behavioral risk factors and the relationship between the STIs/HIV and demographic factors. METHODOLOGY: A cross-sectional survey was conducted between 2013 and 2014 among attendees of the Ministry of Health hospitals. RESULTS: The total number of participants was 3,994 (2,441 males and 1,553 females), with a mean age of 31.95 ± 9.45 years (range 12 to 77 years). The prevalence of STIs and HIV was 6.2% and 0.05% respectively. The mean age for infected people with STIs was 29.42 ± 7.51, vs. 32.12 ± 9.55 for non infected (p < 0.05). There was no diffference between infected and non infected people regarding gender, occupation and marital status. The prevalence of STIs was more commonly reported among non-Saudi (10.9%). Drug use (OR = 4.74; 95%; CI: 3.47-6.48), intravenous drug use (OR = 4.51; 95% CI: 1.45-13.12), illegal sex (OR = 10.7; 95% CI: 7.62-13.32), sex for money (OR = 6.36; 95% CI: 4.52-8.93), sex for pleasure (OR = 9.76; 95% CI: 7.29-13.07) were significantly associated with STIs. CONCLUSION: The prevalence of STIs including HIV in Saudi Arabia is low compared to other countries in the region and globally.

HIV transmission at a Saudi Arabia hemodialysis unit.

BACKGROUND: Hemodialysis is associated with increased risk of healthcare-associated infections but considered a low-risk setting for human immunodeficiency virus (HIV) transmission. We investigated 3 hemodialysis unit (HDU) patients with new HIV infections to determine whether transmission was hemodialysis-associated and to correct factors that contributed to transmission. METHODS: Each patient was evaluated for HIV risk factors. Blood samples were tested to determine relatedness of HIV strains. Clinical data (gathered over 18 months) was reviewed to identify seroconversions at 12 HDUs. Infection prevention and control practices were evaluated at 14 HDUs. FINDINGS: No other HIV seroconversions were identified during the study. HIV gag, pol, and env gene sequences were consistent with a clonal relationship. HIV and hepatitis C virus prevalence rates at one HDU 1 (5.7% and 6.5%, respectively) were higher than for 11 other HDUs (0% and 0.15%, respectively). CONCLUSIONS: Sequencing supports either patient-to-patient or common-source transmission. Infections occurred despite Saudi Arabia's low HIV prevalence and national dialysis policies that emphasize stringent infection prevention and control practices.