Prevalence of sexually transmitted infections in HIV-1 infected pregnant women in Europe

Abstract

We investigated prevalence of sexually transmitted infections (STI) in a cohort of HIV-1-infected pregnant women and described factors associated with STI diagnosis, as a nested study within the European Collaborative Study (ECS). The ECS is a cohort study in which HIV-infected pregnant women are enrolled and their children followed from birth, according to standard clinical and laboratory protocols. Information on STIs diagnosed during pregnancy was collected retrospectively from the antenatal records of women enrolling between January 1999 and October 2005; other variables were obtained from the ECS prospective database. A total of 1,050 women were included: 530 in Western Europe and 520 in Ukraine. Syphilis was the most common bacterial STI (2% prevalence, 95% CI 1.2-3.0). Prevalence of HPV-related genital lesions was 8.6% (95%CI 6.9-10.4) and prevalence of Trichomonas vaginalis was 12.1% (95%CI 10.2-14.2). Women in Ukraine (AOR 10.7, 95%CI 3.7-30.5), single women (AOR 3.9, 95%CI 1.2-12.7), sexual partners of injecting drug users (AOR 3.8, 95%CI 1.4-10.4) and women with CD4 counts <200 cells/mm(3) (AOR 5.4, 95%CI 1.0-28.1) were at increased risk of diagnosis with Chlamydia trachomatis, syphilis or Trichomonas vaginalis. African origin (AOR 1.9, 95%CI 1.1-3.3) and CD4 count <200 cells/mm(3) (AOR 3.4, 95%CI 1.5-7.8) were associated with HSV-2 and/or HPV-related genital lesions. Antenatal screening should be considered an effective tool for diagnosis, treatment and prevention of further transmission of STIs. HIV-infected women should receive adequate screening for STIs during pregnancy together with appropriate counseling and follow-up for treatment and prevention.

Prevalence and factors associated with Chlamydia trachomatis infection among women with HIV in São Paulo

“…In the present study, we found that CT infection was associated with low CD4+ cell counts, and this association confirms the findings from previous Brazilian and European studies (8) (23) . In this context, patients with immunosuppression have an increased risk of infection, and their CD4+ T-cell counts and behavioral risk factors should be considered and monitored by health professionals.…”

“…However, a Canadian study reported a much lower prevalence of CT infection (0.6%) (21) . Our results regarding the prevalence of CT infection are consistent with the results from studies that were performed in Rio de Janeiro (2.2%) (22) , Europe (1%) (23) , and Africa (2.6%) (24) .…”

High Prevalence and Incidence of Asymptomatic Sexually Transmitted Infections During Pregnancy and Postdelivery in KwaZulu Natal, South Africa

“…These findings are consistent with other studies that reported similar trends in behavioral risk among other high-risk population groups. [17][18][19] HIV-infected individuals were more likely to report unprotected sex than their HIV-uninfected counterparts.…”

Behavioral interventions to promote condom use among women living with HIV: a systematic review update

“…Regarding reduction of STI incidence in women living with HIV, two studies individually mentioned favorable effects of behavioral interventions, but the results could not be pooled in a metaanalysis. STI diagnosis is a critical public health outcome in behavioral intervention trials, since solid evidence backs the biological pathways by which STI facilitate HIV transmission and the negative effects of multiple sexually transmitted infections, especially in women living with HIV 4,5,53 . We therefore emphasize that even small reductions in STI incidence could favor critical reductions in HIV morbidity and its associated treatment cost.…”

“…These challenges directly affect their sexual practices. Women living with HIV are at increased risk for sexually transmitted infections (STI) 4,5 , cervical dysplasia, and genital cancer 6,7 . Concurrent STI and HIV also increase the risk of female-to-male HIV transmission during sexual intercourse 5 and the risk of mother-to-child HIV transmission by pregnant women.…”