1. Risk Factors for Incidence of Sexually Transmitted Infections Among Women in a Human Immunodeficiency Virus Chemoprevention Trial
- Author
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Chirenje, Zvavahera Mike, Gundacker, Holly M, Richardson, Barbra, Rabe, Lorna, Gaffoor, Zakir, Nair, Gonasagrie, Mirembe, Brenda Gati, Piper, Jeanna M, Hillier, Sharon, and Marrazzo, Jeanne
- Subjects
Public Health ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Infectious Diseases ,Rare Diseases ,Clinical Trials and Supportive Activities ,Sexually Transmitted Infections ,Prevention ,Clinical Research ,2.4 Surveillance and distribution ,Aetiology ,Infection ,Good Health and Well Being ,Adolescent ,Adult ,Africa South of the Sahara ,Chemoprevention ,Condoms ,Female ,Follow-Up Studies ,HIV Infections ,Humans ,Incidence ,Prospective Studies ,Risk Factors ,Risk Reduction Behavior ,Sexually Transmitted Diseases ,Uganda ,Young Adult ,Zimbabwe ,Biological Sciences ,Medical and Health Sciences ,Clinical sciences ,Epidemiology ,Public health - Abstract
BackgroundIn sub-Saharan Africa, there are limited data on the incidence of sexually transmitted infections (STIs) among women, largely because routine screening for asymptomatic infection is not performed. We conducted a secondary analysis to measure STI incidence rates and determine risk factors for new STI acquisition among women enrolled in the VOICE trial.MethodsWe analyzed data from 4843 women screened for chlamydia, gonorrhoea, syphilis, and trichomonas infection at baseline, annually, at interim visits when clinically indicated and at their study termination visit. Risk reduction counseling and condoms were provided throughout the trial.ResultsTwenty percent of evaluable participants had one or more curable STIs at baseline. Over 5660 person-years at risk (PYAR) of observation, incidence rates were 13.8% (95% confidence interval [CI], 12.7-14.8) PYAR for chlamydia, 3.5% (95% CI, 3.0-4.1) PYAR gonorrhea, 0.1% (95% CI, 0.6-1.1) PYAR syphilis, and 6.6% (95% CI, 5.8-7.2) PYAR trichomoniasis. South African sites had the highest incidence of chlamydia. The Uganda site had the highest incidence of gonorrhoea and syphilis, and Zimbabwe the lowest incidence overall. The majority of these cases were diagnosed at a routine scheduled testing visit. In multivariate analysis, positive baseline STI, younger than 25 years, being unmarried, and some alcohol consumption were associated with acquiring a new STI.ConclusionsWe observed high rates of STIs during follow up among women in the VOICE study. Women living in human immunodeficiency virus endemic countries should be screened for common STIs.
- Published
- 2017