Sexually transmitted infections, the silent partner in HIV-infected women in Zimbabwe

Abstract

Background: Coinfection rates of HIV and sexually transmitted infections (STIs) are not widely reported in Zimbabwe and no local guidelines regarding the screening of STIs in people living with HIV exist.Objectives: This cross-sectional study was conducted to determine the prevalence and associated risk factors for STI coinfection in a cohort of HIV-infected women.Methods: Between January and June 2016, 385 HIV-infected women presenting for routine cervical cancer screening were tested for five STIs: Neisseria gonorrhoeae (NG), Chlamydia trachomatis(CT), Trichomonas vaginalis (TV), Herpes Simplex Virus (HSV) type 2 and Treponema pallidum (TP). Socio-demographic characteristics and sexual history were recorded. Multiple logistic regression was used to identify factors associated with the diagnosis of non-viral STIs.Results: Two hundred and thirty-three participants (60.5%) had a confirmed positive result for at least one STI: HSV 2 prevalence 52.5%, TV 8.1%, CT 2.1%, NG 1.8% and TP 11.4%. Eighty-seven per cent of the women were asymptomatic for any STI; 62.3% of women with a non-viral STI were asymptomatic. Women who had attended tertiary education were 90% less likely to have a non-viral STI (adjusted odds ratio [aOR]: 0.10, 95% confidence interval [CI]: 0.03–0.39, p < 0.01). Having more than three lifetime sexual partners was a significant predictor for a non-viral STI diagnosis (aOR: 3.3, 95% CI: 1.5–7.2, p < 0.01).Conclusion: A high prevalence of predominantly asymptomatic STIs is reported in a cohort of HIV-infected women. Syndromic management results in underdiagnosis of asymptomatic patients. More than three lifetime sexual partners and less formal education are risk factors for coinfection with non-viral STI. High-risk women should be screened using aetiological methods.

Urban-rural disparity in sociodemographic characteristics and sexual behaviors of HIV-positive adolescent girls and young women and their perspectives on their male sexual partners: A cross-sectional study in Zimbabwe

“…In-depth interviews with some of our participants revealed that low condom use was due to their lack of confidence about suggesting condom use to their partners, their low HIV risk perception due to poor comprehensive HIV knowledge, and intimate partner violence [30]. Low condom use among married couples and HIV-positive women has been reported in previous studies in Zimbabwe [71][72][73]. The lack of significant urban-rural disparity on condom use was not expected, and we think that it might be due in part to social desirability bias.…”

High Prevalence of Sexually Transmitted Infections and Risk Factors Among HIV-Positive Individuals in Yunnan, China

“…In the present study, a rather high STI prevalence among HIVpositive individuals was con rmed, namely, 47.0% (191/406) in total,45.1% (91/204) in ART-naive individuals and 49.0% (99/202) in ART individuals. This prevalence is much higher than the 5.3% observed in the HIVpositive individuals in Nepal [19], the 11.1% detected in the women living with HIV/AIDS (WLHA) in Uganda [20] and the 23.5% of HIV-infected MSM in China [21], but the prevalence was less than the 60.6% of female sex workers in Peru [22] and the 60.5% of HIV-infected Women in Zimbabwe [23]. The prevalence of genital tract discomfort was 0.5%…”

Cervical cancer screening outcomes in Zambia, 2010–19: a cohort study

“…34 Thus, it is possible that women with HIV are more likely to be misclassified for increased cervical cancer risk as they might be less likely to clear infections because of their immune status. 35,36 These findings could also indicate that women with HIV have earlier disease progression, meaning that these women should be engaged in screening at a younger age. Efforts to change screening methods to HPV screening are underway and could help to prevent misclassification of disease in women with HIV.…”