Original Research

Sexually transmitted infections, the silent partner in HIV-infected women in Zimbabwe

Sara Lowe, Tinashe Mudzviti, Ardele Mandiriri, Tinei Shamu, Petronella Mudhokwani, Cleophas Chimbetete, Ruedi Luethy, Margaret Pascoe
Southern African Journal of HIV Medicine | Vol 20, No 1 | a849 | DOI: https://doi.org/10.4102/sajhivmed.v20i1.849 | © 2019 Sara Lowe, Tinashe Mudzviti, Ardele Mandiriri, Tinei Shamu, Petronella Mudhokwani, Cleophas Chimbetete, Ruedi Luethy, Margaret Pascoe | This work is licensed under CC Attribution 4.0
Submitted: 12 March 2018 | Published: 23 January 2019

About the author(s)

Sara Lowe, AIDS Healthcare Foundation, Parirenyatwa Centre of Excellence, Parirenyatwa Hospital, Zimbabwe; and, Department of Medicine, College of Health Sciences, University of Zimbabwe, Zimbabwe
Tinashe Mudzviti, Newlands Clinic, Zimbabwe; and School of Pharmacy, College of Health Sciences, University of Zimbabwe, Zimbabwe
Ardele Mandiriri, Newlands Clinic, Zimbabwe
Tinei Shamu, Newlands Clinic, Zimbabwe
Petronella Mudhokwani, Newlands Clinic, Zimbabwe
Cleophas Chimbetete, Newlands Clinic, Zimbabwe
Ruedi Luethy, Newlands Clinic, Zimbabwe
Margaret Pascoe, Newlands Clinic, Zimbabwe


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Abstract

Background: Coinfection rates of HIV and sexually transmitted infections (STIs) are not widely reported in Zimbabwe and no local guidelines regarding the screening of STIs in people living with HIV exist.

Objectives: This cross-sectional study was conducted to determine the prevalence and associated risk factors for STI coinfection in a cohort of HIV-infected women.

Methods: Between January and June 2016, 385 HIV-infected women presenting for routine cervical cancer screening were tested for five STIs: Neisseria gonorrhoeae (NG), Chlamydia trachomatis(CT), Trichomonas vaginalis (TV), Herpes Simplex Virus (HSV) type 2 and Treponema pallidum (TP). Socio-demographic characteristics and sexual history were recorded. Multiple logistic regression was used to identify factors associated with the diagnosis of non-viral STIs.

Results: Two hundred and thirty-three participants (60.5%) had a confirmed positive result for at least one STI: HSV 2 prevalence 52.5%, TV 8.1%, CT 2.1%, NG 1.8% and TP 11.4%. Eighty-seven per cent of the women were asymptomatic for any STI; 62.3% of women with a non-viral STI were asymptomatic. Women who had attended tertiary education were 90% less likely to have a non-viral STI (adjusted odds ratio [aOR]: 0.10, 95% confidence interval [CI]: 0.03–0.39, p < 0.01). Having more than three lifetime sexual partners was a significant predictor for a non-viral STI diagnosis (aOR: 3.3, 95% CI: 1.5–7.2, p < 0.01).

Conclusion: A high prevalence of predominantly asymptomatic STIs is reported in a cohort of HIV-infected women. Syndromic management results in underdiagnosis of asymptomatic patients. More than three lifetime sexual partners and less formal education are risk factors for coinfection with non-viral STI. High-risk women should be screened using aetiological methods.


Keywords

HIV; herpes; trichomonas vaginalis; neisseria gonorrhoeae; chlamydia trachomatis; Sexually Transmitted Infection

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