Sexually transmitted infections in the older woman

Drew, Olivia; Sherrard, Jackie

doi:10.1258/mi.2008.008020

Cited by 22 publications

(17 citation statements)

References 12 publications

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“…Assumptions about older adults not engaging in sexual behaviour [15] have limited the reach and relevance of targeted prevention messaging. Additionally, the thinning of the vaginal wall after menopause increases the chances of lesions thus increasing risk of HIV transmission during sex [27]. Lastly, it is possible that as the partners of those aged 50 and older die, older adults seek new relationships that put them at increased risk of HIV transmission.…”

Section: Discussionmentioning

confidence: 99%

Rising Levels of HIV Infection in Older Adults in Eastern Zimbabwe

et al. 2016

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BackgroundWith the scale-up of antiretroviral treatment across Africa, many people are living longer with HIV. Understanding the ageing of the HIV cohort and sexual behaviour among older adults are important for appropriately responding to the changing demographics of people living with HIV.MethodsWe used data from a large population-based open cohort in eastern Zimbabwe to examine HIV prevalence trends and incidence among those aged 45 years and older. Five survey rounds have been completed between 1998 and 2011. Incidence was analysed using midpoint between last negative and first positive HIV test.ResultsAcross the survey rounds, 13,071 individuals were followed for 57,676 person years. While HIV prevalence among people aged 15–44 has fallen across the five rounds, HIV prevalence among those aged 45–54 has increased since the 2006–08 survey round. In the 2009–11 round, HIV prevalence among men aged 45–54 was 23.4% compared to 11.0% among those aged 15–44. HIV positive people aged 45–54 now represent more than 20% of all those living with HIV in Manicaland. Among those aged 45 years and older, there were 85 seroconversions in 11,999 person years for an HIV incidence of 0.708 per 100 person years. Analysis of cohort data and assessment of behavioural risk factors for HIV infection among older people shows significantly lower levels of condom use among older adults and a number of seroconversions past the age of 50.ConclusionsThe cohort of people living with HIV is ageing in Zimbabwe and the behaviour of older adults puts them at risk of HIV infection. Older adults must be included in both HIV prevention and treatment programs.

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Section: Discussionmentioning

confidence: 99%

Rising Levels of HIV Infection in Older Adults in Eastern Zimbabwe

et al. 2016

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“…The thinning of the vaginal wall after menopause increases the risk of HIV transmission during sex. 41 Practices such as wife inheritance and ritual cleansing, in which a widow is expected to either marry or have sex with relatives of the deceased husband, can increase older women's exposure to the virus. 42 Additionally, many older people are poor and may not be able to afford health services.…”

Section: Discussionmentioning

confidence: 99%

HIV infection in older adults in sub-Saharan Africa: extrapolating prevalence from existing data

Negin

Cumming

2010

Bull. World Health Organ.

203

178

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“…Colonization with lactobacilli is also associated with a lower risk of pelvic inflammatory disease and pregnancy-related complications, including pre-term labor 1, 2 . In post-menopausal women, a decrease in Lactobacillus relative abundance is associated with signs of vulvovaginal atrophy 5 and increased risk of urinary tract and sexually transmitted infections 6, 7 . Lactobacillus therefore plays an important beneficial role in health of both pre- and post-menopausal women.…”

Section: Introductionmentioning

confidence: 99%

Exploratory comparison of vaginal glycogen and Lactobacillus levels in premenopausal and postmenopausal women

et al. 2015

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Objective Previous studies have suggested that glycogen expression in vaginal epithelium decreases at menopause, resulting in reduced levels of lactobacilli. However, free glycogen in genital fluids and its relationship to Lactobacillus levels has not been compared in pre- and post-menopausal women. Methods 82 cervico-vaginal lavage samples were collected at different phases of the menstrual cycle from 11 pre-menopausal (4 HIV-uninfected and 7 HIV-infected) and 12 post-menopausal (7 HIV-uninfected and 5 HIV-infected) women over a 1–3 month period. Free glycogen was quantified in genital fluid. Lactobacillus levels were quantified by real time PCR. Estrogen and progesterone levels in blood were determined by ELISA. Results Free glycogen was detected in both pre- and post-menopausal women. Across all samples, those from post-menopausal women had significantly lower levels of free glycogen than those from pre-menopausal women (median 0.002 vs. 0.065 µg/µl, respectively; p = 0.03). Lactobacillus levels correlated positively with free glycogen in both pre- (Spearman r=0.68, p <0.0001) and post-menopausal women (r=0.60, p <0.002). Samples from pre-menopausal women had higher Lactobacillus levels and a lower vaginal pH (median log=8.1; median pH= 4) than those from post-menopausal women (median log=7.1; median pH=4.6) although these differences were not significant. HIV status had no significant effect on these relationships. Conclusion Free glycogen was detected in both pre- and post-menopausal women and correlated with Lactobacillus in both groups. These results point to the complexity of the relationship between menopause and vaginal microbiota and indicate that more careful studies of the role played by glycogen are warranted.

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Sexually transmitted infections in the older woman

Cited by 22 publications

References 12 publications

Rising Levels of HIV Infection in Older Adults in Eastern Zimbabwe

Rising Levels of HIV Infection in Older Adults in Eastern Zimbabwe

HIV infection in older adults in sub-Saharan Africa: extrapolating prevalence from existing data

Exploratory comparison of vaginal glycogen and Lactobacillus levels in premenopausal and postmenopausal women

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