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 journalArticle

19 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
  • Pharmacology (medical)
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Converging epidemics of sexually transmitted infections and bacterial vaginosis in southern African female adolescents at risk of HIV'. Together they form a unique fingerprint.

Cite this