Differences between nonnational and indigenous patients with sexually transmitted infections in Italy and insight into the control of sexually transmitted infections

Background: To determine the health needs non-nationals, information on disease occurrence is fundamental. Goals: The goal of this study was to assess the clinical and behavioral characteristics of non-Italians with a new sexually transmitted infection (STI). Methods: Data were taken from Italy's National STI Surveillance System (1991-1999). Results: Of the 61,798 STI cases reported from January 1991 to December 1999, 6847 (11.2%) were diagnosed among non-Italians, 47.1% of whom were Africans. Being a non-Italian patient with an STI was associated with male gender (adjusted odds ratio [AOR], 1.19; 95% confidence interval [CI], 1.11-1.27), youngest age (AOR, 1.71; 95% CI, 1.43-2.04), no formal education (AOR, 20.25; 95% CI, 17.5123.42), and having contracted the STI abroad (AOR, 13.98; 95% CI, 12.59-15.54). The HIV-1 prevalence among non-Italian patients with STIs was 5.5% (95% CI, 4.9-6.2), with large differences by continent of origin. The highest prevalence was found among European injecting drug users (54.1%; 95% CI, 37.1-70.1), South American homosexual men (41.6%; 95% CI, 32.0-51.8), and heterosexuals from Sub-Saharan Africa (8.9%; 95% CI, 7.2-10.8). Conclusions: Non-Italian patients with STIs seem to consist mainly of migrants, and STI transmission patterns differ from those among Italians; this information is important for developing targeted STI prevention efforts.