Journal Article

Neisseria gonorrhoeae and Chlamydia trachomatis infection in HIV-1-infected women taking antiretroviral therapy: a prospective cohort study from Burkina Faso

Mayaud, Philippe, Segondy, Michel, Low, Andrea J, Mabey, David, Meda, Nicolas, Konate, Issouf, Weiss, Helen A, Vickerman, Peter, van de Perre, Philippe, Nagot, Nicolas

2014

Overview

Objectives Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) are common sexually transmitted infections (STI). We assessed the cumulative risk of NG and CT in a cohort of HIV-1-infected high-risk women taking antiretrovirals over 4 years in Burkina Faso. Methods Between March 2007 and February 2011, participants were followed every 3–6 months. At each visit, participants underwent a gynaecological examination with collection of cervical and vaginal swabs. Random-effects logistic regression models were used to analyse associations of NG and CT infection with behavioural and biological factors. Results 172 women had samples tested for NG and CT during the study period, in a total of 1135 visits. NG was detected in 6.4% of women (11/172, 95% CI 2.7 to 10.1) at a rate of 2.76 cases (95% CI 1.53 to 4.99) per 100 person-years. CT was detected in 1.7% (3/172, 95% CI 0 to 3.7) of women at a rate of 0.75 cases (95% CI 0.24 to 2.34) per 100 person-years. The majority of women were asymptomatic (9/14). In the multivariable model, the presence of NG or CT was associated with tobacco use (aOR=11.85, 95% CI 1.13 to 124.17), and concurrent genital HIV-1 RNA shedding (aOR=4.78, 95% CI 1.17 to 19.46). Higher levels of education (aOR=0.17, 95% CI 0.03 to 0.92), and age greater than 35 years (aOR=0.07, 95% CI 0.01 to 0.92) were associated with lower odds of infection. Conclusions The risk of NG or CT infection remains low among high-risk women in Bobo-Dioulasso. This provides some evidence that antiretroviral use does not contribute to behavioural disinhibition. The asymptomatic nature of most infections underscores the need for regular screening and treatment of STIs in core groups.

• Publisher: BMJ Publishing Group,BMJ Publishing Group LTD
• Subject: Acquired immune deficiency syndrome / Adolescent / Adult / AIDS / AIDS-Related Opportunistic Infections - diagnosis / AIDS-Related Opportunistic Infections - drug therapy / AIDS-Related Opportunistic Infections - epidemiology / AIDS-Related Opportunistic Infections - microbiology / Anti-HIV Agents - therapeutic use / Bacterial diseases / Bacterial diseases of the genital system / Biological and medical sciences / Burkina Faso - epidemiology / Chlamydia / Chlamydia Infections - diagnosis / Chlamydia Infections - epidemiology / Chlamydia Infections - prevention & control / Chlamydia trachomatis - isolation & purification / Clinical / Cohort Studies / Coinfection / Epidemiology. Vaccinations / Female / General aspects / Gonorrhea / Gonorrhea - diagnosis / Gonorrhea - epidemiology / Gonorrhea - prevention & control / Herpes viruses / HIV / HIV Infections - drug therapy / HIV Infections - epidemiology / HIV-1 - drug effects / Human bacterial diseases / Human immunodeficiency virus / Human infectious diseases. Experimental studies and models / Humans / Infections / Infectious diseases / Male / Mass Screening / Medical sciences / Middle Aged / Needs Assessment / Neisseria gonorrhoeae - isolation & purification / Prospective Studies / Risk Assessment / Risk Factors / Sentinel Surveillance / Sexual Behavior / Sexually transmitted diseases / STD / Vagina