Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e318191ba01
Articles

Risk Factors for Incidence of Sexually Transmitted Infections Among Women in South Africa, Tanzania, and Zambia: Results From HPTN 055 Study

Kapiga, Saidi MD*; Kelly, Cliff MS†; Weiss, Stephen PHD‡; Daley, Tara MS*; Peterson, Leigh PHD§; Leburg, Corey MHS†; Ramjee, Gita PHD∥

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Abstract

Objective: To determine risk factors for sexually transmitted infections (STIs) among women in Durban and Hlabisa (South Africa), Moshi (Tanzania), and Lusaka (Zambia).

Study Design: Between 2003 and 2004, 958 women at risk of STIs were enrolled in a 1-year prospective study. They were interviewed at each monthly visit, and samples for STI testing were collected during quarterly and other visits when clinically indicated.

Results: The incidence of infections as measured in person-years at risk (PYAR) was as follows: overall trichomoniasis, 31.9/100 PYAR; chlamydial infection in South Africa, 19.5/100 PYAR; chlamydial infection in Tanzania and Zambia, 4.9/100 PYAR; gonorrhea in South Africa, 16.5/100 PYAR; gonorrhea in Tanzania and Zambia, 5.3/100 PYAR; overall syphilis, 7.5/100 PYAR; and overall HIV, 3.8/100 PYAR. The incidence of most STIs was highest among the South African sites, where chlamydial infection and gonorrhea were detected by using a more sensitive assay. Independent risk factors included age, hormonal contraceptive methods, and measures of sexual behavior, including number of sex partners and occurrence of anal sex in the past 3 months. Women with incident HIV infection were at increased risk of chlamydial infection [odds ratio (OR) = 5.5, 95% confidence interval (CI): 2.0–15.2]and gonorrhea (OR = 5.7, 95% CI: 1.9–17.0) in South African sites. Despite ongoing counseling during the study, high-risk sexual behaviors were common, and consistent condom use remained low.

Conclusions: The incidence of STIs, including HIV, was high among women in this study. These findings highlight the urgent need for effective HIV/STI prevention programs in this population.

© Copyright 2009 American Sexually Transmitted Diseases Association

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