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

doi:10.1177/0956462417740487

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

Cell & Developmental Biology

Research output: Contribution to journal › Article › peer-review

47 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 language	English (US)
Pages (from-to)	531-539
Number of pages	9
Journal	International Journal of STD and AIDS
Volume	29
Issue number	6
DOIs	https://doi.org/10.1177/0956462417740487
State	Published - May 1 2018

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by grants from the European and Developing Countries Clinical Trials Partnership (EDCTP) Strategic Primer grant (SP.2011.41304.038) and the South African Department of Science and Technology (DST/CON 0260/2012). SLB was supported by the HIV Vaccine Trials Network SHAPe Program, the Fogarty Foundation and the South African Medical Research Council (MRC). SD was supported by the National Research Foundation (NRF) of South Africa and the Poliomyelitis Research Foundation. This work (ALW) was partially based upon research supported by the South African Research Chairs Initiative of the Department of Science and Technology and National Research Foundation. The DTHF also recognizes the support from ViiV health care in their YouthShield program. Perinatal HIV Research Unit was supported through funding from the South African MRC.

Keywords

Female
adolescents
bacterial vaginosis
sexually transmitted infections
syndromic management

ASJC Scopus subject areas

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1177/0956462417740487

Cite this

@article{e092558a31634d31af563f15ed8e4b02,

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

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.",

keywords = "Female, adolescents, bacterial vaginosis, sexually transmitted infections, syndromic management",

author = "{for the Women{\textquoteright}s Initiative in Sexual Health (WISH) study team} and Barnabas, {Shaun L.} and Smritee Dabee and Passmore, {Jo Ann S.} and Jaspan, {Heather B.} and Lewis, {David A.} and Jaumdally, {Shameem Z.} and Hoyam Gamieldien and Lindi Masson and Etienne Muller and Maseko, {Venessa D.} and Nonhlanhla Mkhize and Zizipho Mbulawa and Williamson, {Anna Lise} and Gray, {Clive M.} and Hope, {Thomas J.} and Francesca Chiodi and Janan Dietrich and Glenda Gray and Bekker, {Linda Gail}",

note = "Publisher Copyright: {\textcopyright} 2017, {\textcopyright} The Author(s) 2017.",

year = "2018",

month = may,

day = "1",

doi = "10.1177/0956462417740487",

language = "English (US)",

volume = "29",

pages = "531--539",

journal = "International Journal of STD and AIDS",

issn = "0956-4624",

publisher = "SAGE Publications Ltd",

number = "6",

}

TY - JOUR

T1 - Converging epidemics of sexually transmitted infections and bacterial vaginosis in southern African female adolescents at risk of HIV

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

AU - Barnabas, Shaun L.

AU - Dabee, Smritee

AU - Passmore, Jo Ann S.

AU - Jaspan, Heather B.

AU - Lewis, David A.

AU - Jaumdally, Shameem Z.

AU - Gamieldien, Hoyam

AU - Masson, Lindi

AU - Muller, Etienne

AU - Maseko, Venessa D.

AU - Mkhize, Nonhlanhla

AU - Mbulawa, Zizipho

AU - Williamson, Anna Lise

AU - Gray, Clive M.

AU - Hope, Thomas J.

AU - Chiodi, Francesca

AU - Dietrich, Janan

AU - Gray, Glenda

AU - Bekker, Linda Gail

PY - 2018/5/1

Y1 - 2018/5/1

N2 - 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.

AB - 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.

KW - Female

KW - adolescents

KW - bacterial vaginosis

KW - sexually transmitted infections

KW - syndromic management

UR - http://www.scopus.com/inward/record.url?scp=85042632677&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042632677&partnerID=8YFLogxK

U2 - 10.1177/0956462417740487

DO - 10.1177/0956462417740487

M3 - Article

C2 - 29198180

AN - SCOPUS:85042632677

SN - 0956-4624

VL - 29

SP - 531

EP - 539

JO - International Journal of STD and AIDS

JF - International Journal of STD and AIDS

IS - 6

ER -

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

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this