Sexually Transmitted Diseases

Skip Navigation LinksHome > July 2012 - Volume 39 - Issue 7 > Urethritis/Cervicitis Pathogen Prevalence and Associated Ris...
Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e31824cbecc
Original Study

Urethritis/Cervicitis Pathogen Prevalence and Associated Risk Factors Among Asymptomatic HIV-Infected Patients in South Africa

Lewis, David A. FRCP(UK), PhD*,†; Chirwa, Tobias F. PhD; Msimang, Veerle M. Y. MSc*; Radebe, Frans M. MSc*; Kamb, Mary L. MD, MPH§; Firnhaber, Cynthia S. MD, MS†,¶

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Abstract

Background: To determine sexually transmitted infection (STI) prevalence, and patient characteristics associated with detection of urethritis/cervicitis pathogens, among HIV-infected individuals offered voluntary STI screening at a South African HIV treatment center.

Methods: Individuals, asymptomatic for genital discharge, were screened for Neisseria gonorrhoeae (NG), Chlamydia trachomatis, Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) infections (real-time polymerase chain reaction assay), for syphilis and herpes simplex type 2 (serologically), and for bacterial vaginosis and Candida (microscopy, women only). Patients' most recent CD4 and viral load results were recorded. Demographic, clinical, and behavioral data were collected by nurse-administered questionnaire.

Results: Compared with men (n = 551), women (n = 558) were younger (mean age, 35.0 vs. 37.9 years; P < 0.001), reported more STIs in the past year (65.5% vs. 56.5%; P = 0.002), had more urethritis/cervicitis pathogens detected (21.3% vs.16.4%, P = 0.035), and were less aware of their partner's HIV status (53.1% vs. 62.3%; P = 0.007). The overall prevalence of individual urethritis/cervicitis pathogens was TV (7.6%), MG (6.1%), NG (5.4%), and C. trachomatis (2.1%). Multivariate analysis highlighted 4 significant factors associated with the detection of specific urethritis/cervicitis pathogens, namely female gender (TV, adjusted odds ratio [aOR] 2.53, 95% confidence interval [CI]: 1.47–4.37), having a regular sexual partner in the past 3 months (NG, aOR 2.26, 95% CI: 1.01–5.08), suboptimal condom use with regular partners (TV, aOR 2.07, 95% CI: 1.25–3.42), and a history of genital warts in the past year (NG, 2.25, 95% CI: 1.26–4.03).

Conclusions: Asymptomatic urethritis/cervicitis pathogens were highly prevalent in this population. Few urethritis/cervicitis pathogen-associated patient characteristics were identified, emphasizing the need for affordable STI diagnostics to screen HIV-infected patients.

© Copyright 2012 American Sexually Transmitted Diseases Association

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