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- Title
Converging epidemics of sexually transmitted infections and bacterial vaginosis in southern African female adolescents at risk of HIV.
- Authors
Barnabas, Shaun L.; Dabee, Smritee; Passmore, Jo-Ann S.; Jaspan, Heather B.; Lewis, David A.; Jaumdally, Shameem Z.; Gamieldien, Hoyam; Masson, Lindi; Muller, Etienne; Maseko, Venessa D.; Mkhize, Nonhlanhla; Mbulawa, Zizipho; Williamson, Anna-Lise; Gray, Clive M.; Hope, Thomas J.; Chiodi, Francesca; Dietrich, Janan; Gray, Glenda; Bekker, Linda-Gail; Women’s Initiative in Sexual Health (WISH) study team
- Abstract
Adolescents in Africa are at high risk for HIV infection, other sexually transmitted infections (STIs) and bacterial vaginosis (BV). Since behavior and burden of STIs/BV may influence HIV risk, behavioral risk factors and prevalence of STIs/BV were compared in HIV-seronegative adolescent females (n = 298; 16-22 years) from two South African communities (Soweto and Cape Town). STIs ( Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV)-1, HSV-2, Treponema pallidum, and Haemophilus ducreyi) were detected by multiplex polymerase chain reaction, human papillomavirus (HPV) by Roche Linear Array, and BV by Nugent scoring. Rates of BV (Nugent ≥7; 46.6%) and HPV (66.8%) were high in both communities. Prevalence of C. trachomatis and N. gonorrhoeae were >2-fold higher in Cape Town than Soweto (Chlamydia: 42% [62/149] versus 18% [26/148], p < 0.0001; gonorrhoea 11% [17/149] versus 5% [7/148], p = 0.05). Only 24% of adolescents with vaginal discharge-causing STIs or BV were symptomatic. In South African adolescents, clinical symptoms compatible with vaginal discharge syndrome had a sensitivity of 23% and specificity of 85% for the diagnosis of discharge-causing STI or BV. In a region with high HIV prevalence and incidence, >70% of young women with treatable conditions that could enhance HIV risk would have been missed because they lacked symptoms associated with syndromic management.
- Subjects
SOUTH Africa; EPIDEMICS; SEXUALLY transmitted diseases; BACTERIAL vaginitis; TEENAGE girls; HIV infection risk factors; HIV infection epidemiology; HIV prevention; EPIDEMIOLOGY of sexually transmitted diseases; HIV seronegativity; RESEARCH; RESEARCH methodology; EVALUATION research; POVERTY areas; COMPARATIVE studies; DISEASE prevalence
- Publication
International Journal of STD & AIDS, 2018, Vol 29, Issue 6, p531
- ISSN
0956-4624
- Publication type
journal article
- DOI
10.1177/0956462417740487