Burden of sexually transmitted infections from acute HIV infection among women in South Africa

• Verfasst von: Asare, Kwabena [VerfasserIn]
• Verfasst von: Osman, Farzana [VerfasserIn]
• Verfasst von: Ngcapu, Sinaye [VerfasserIn]
• Verfasst von: Vandormael, Alain [VerfasserIn]
• Verfasst von: Naicker, Nivashnee [VerfasserIn]
• Verfasst von: Khanyile, Mlungisi [VerfasserIn]
• Verfasst von: Mindel, Adrian [VerfasserIn]
• Verfasst von: Abdool Karim, Salim S. [VerfasserIn]
• Verfasst von: Tomita, Andrew [VerfasserIn]
• Verfasst von: Garrett, Nigel [VerfasserIn]
• Titel: Burden of sexually transmitted infections from acute HIV infection among women in South Africa
• Titelzusatz: evidence from a prospective cohort study
• Verf.angabe: Kwabena Asare, Farzana Osman, Sinaye Ngcapu, Alain Vandormael, Nivashnee Naicker, Mlungisi Khanyile, Adrian Mindel, Salim S. Abdool Karim, Andrew Tomita, Nigel Garrett
• E-Jahr: 2022
• Jahr: [October 2022]
• Umfang: 8 S.
• Illustrationen: Diagramme
• Fussnoten: Gesehen am 26.10.2022
• Titel Quelle: Enthalten in: Annals of epidemiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1990
• Jahr Quelle: 2022
• Band/Heft Quelle: 74(2022), Seite 132-139
• ISSN Quelle: 1873-2585
• DOI: doi:10.1016/j.annepidem.2022.08.038
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Human Immunodeficiency Virus
• Sach-SW: Sexually transmitted infections
• Sach-SW: Women living with HIV
• K10plus-PPN: 1820052605

Abstract

Purpose - HIV and other sexually transmitted infections (STIs) often co-occur. However, less evidence exists on the long-term STI dynamics among persons living with HIV in sub-Saharan Africa to inform interventions. We investigated the incidence, prevalence and factors associated with STIs, starting from acute HIV infection in a cohort of South African women. - Methods - The CAPRISA002 study enrolled women with acute HIV infection and performed STI testing and treatment 1-2 times annually from 2004-2020. We estimated STI incidence, re-infection, and prevalence trends before and after antiretroviral treatment (ART). We fitted Cox regression models to identify factors associated with STIs. - Results - We followed up 235 women (median age = 25 years, IQR 22-29) for 7.5 years (IQR 5.7-10.8). New STI and re-infection cases per 100 person-years (PYs) were 5.1 and 9.5 for Neisseria gonorrhoeae (NG), 7.4 and 14.7 for Chlamydia trachomatis (CT), 8.0 and 26.6 for Trichomonas vaginalis (TV), 7.7 and 16.7 for Mycoplasma genitalium (MG) and 25.2 and 37.3 for any STI. STI incidence, was associated with HIV log10 viral load (AHR = 1.24, 95% CI 1.06-1.44), active syphilis (AHR = 16.55, 95% CI 7.49-36.55), a positive HSV-2 PCR (AHR = 1.54, 95% CI 1.01-2.35), bacterial vaginosis (AHR = 1.48, 95% CI 1.01-2.18), recent regular sexual partners at enrolment (one vs none: AHR = 2.62, 95% CI 1.41-4.87; two plus vs none: AHR = 3.68, 95% CI 1.79-7.59) and age (5-year fold: AHR = 0.80, 95% CI 0.70-0.92). - Conclusion - The persistent STI/HIV co-infection burden among South African women highlights that early HIV diagnosis and ART initiation needs to be combined with better STI care for women and their partners to prevent HIV and STI transmission.