Converging epidemics of sexually transmitted infections and bacterial vaginosis in southern African female adolescents at risk of HIV

for the Women’s Initiative in Sexual Health (WISH) study team

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)531-539
Number of pages9
JournalInternational Journal of STD and AIDS
Volume29
Issue number6
DOIs
StatePublished - May 1 2018

Keywords

  • Female
  • adolescents
  • bacterial vaginosis
  • sexually transmitted infections
  • syndromic management

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Pharmacology (medical)

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