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The relative contribution of viral and bacterial sexually transmitted infections on HIV acquisition in southern African women in the Methods for Improving Reproductive Health in Africa study.
- Source :
-
International journal of STD & AIDS [Int J STD AIDS] 2011 Apr; Vol. 22 (4), pp. 218-24. - Publication Year :
- 2011
-
Abstract
- We assess the relative contribution of viral and bacterial sexually transmitted infections (STIs) on HIV acquisition among southern African women in a nested case-control study within the Methods for Improving Reproductive Health in Africa (MIRA) trial. Cases were women with incident HIV infection; controls were HIV-uninfected at the time of case seroconversion selected in a 1 to 3 case to control ratio (risk-set sampling), matched on study site and time of follow-up. Conditional logistic regression models were used to calculate adjusted odds ratios (AORs) and population-attributable fractions (PAF). Among 4948 enrolled women, we analysed 309 cases and 927 controls. The overall HIV incidence rate was 4.0 per 100 women-years. The incidence of HIV infection was markedly higher in women who had prevalent Herpes simplex virus type 2 (HSV-2) (AOR: 2.14; 95% confidence interval [CI]: 1.55-2.96), incident HSV-2 (AOR: 4.43; 95% CI: 1.77-11.05) and incident Neisseria gonorrhoeae (AOR: 6.92; 95% CI: 3.01-15.90). The adjusted PAF of HIV incidence for prevalent HSV-2 was 29.0% (95% CI: 16.8-39.3), for incident HSV-2 2.1% (95% CI: 0.6-3.6) and for incident N. gonorrhoeae 4.1% (95% CI: 2.5-5.8). Women's greatest risk factors for HIV acquisition were incident bacterial and viral STIs. Women-centred interventions aimed at decreasing HIV incidence in young African women need to address these common co-morbid conditions.
- Subjects :
- Adult
Case-Control Studies
Condoms statistics & numerical data
Contraceptive Devices, Female statistics & numerical data
Female
Gonorrhea epidemiology
Gonorrhea microbiology
Gonorrhea prevention & control
HIV Infections prevention & control
HIV Infections virology
HIV-1 isolation & purification
Herpes Genitalis epidemiology
Herpes Genitalis prevention & control
Herpes Genitalis virology
Herpesvirus 2, Human
Humans
Incidence
Logistic Models
Neisseria gonorrhoeae
Odds Ratio
Risk Factors
Sexually Transmitted Diseases epidemiology
Sexually Transmitted Diseases prevention & control
South Africa epidemiology
Treatment Outcome
Young Adult
Zimbabwe epidemiology
Gonorrhea complications
HIV Infections epidemiology
Herpes Genitalis complications
Sexually Transmitted Diseases complications
Subjects
Details
- Language :
- English
- ISSN :
- 1758-1052
- Volume :
- 22
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- International journal of STD & AIDS
- Publication Type :
- Academic Journal
- Accession number :
- 21515755
- Full Text :
- https://doi.org/10.1258/ijsa.2010.010385