Lower genital tract infections among HIV-infected and high-risk uninfected women: Findings of the Women's Interagency HIV Study (WIHS)

Background and Objectives: Few comparisons of factors associated with sexually transmitted diseases (STDs) and HIV are available for representative samples of American women. Goal of the Study: To compare factors associated with STDs in a large sample of women infected with HIV and women not infected with HIV. Study Design: A cross-sectional analysis of STDs in 2,058 women seropositive (HIV+) for HIV and 567 women seronegative (HIV-) for HIV. Results: HIV+ women were more likely than HIV- women to report previous STDs, with the exceptions of chlamydia and bacterial vaginosis. Both HIV status and CD4 lymphocyte count were associated with evidence of genital ulcerations, warts, and vaginal candidiasis (p <0.001 for all). HIV- women were more apt to report recent vaginal intercourse (p <0.001), a factor that was independently associated with the occurrence of bacterial and protozoan infections. CD4 lymphocyte depletion was the factor most closely associated with the expression of chronic viral infections. Conclusions: In this North American cohort, HIV+ women were more likely than HIV- women to report previous genital tract infections and symptoms. However, the HIV+ women reported less recent sexual activity and few gonococcal or chlamydial infections.