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Population prevalence of sexually transmitted infections in a high HIV burden district in KwaZulu-Natal, South Africa: Implications for HIV epidemic control.
Int J Infect Dis. 2020 Jun 17; 98:130-137.IJ

Abstract

BACKGROUND

Sexually transmitted infections (STIs) and Human immunodeficiency virus (HIV) share a complex bidirectional relationship, however, population prevalence and the association between the presence of STIs and HIV in a high HIV burden district in KwaZulu-Natal, South Africa is not known.

METHODS

A total of 9812 participants aged 15-49 years were enrolled in a cross-sectional population-based household survey. Participants completed a structured questionnaire and provided first-pass urine (males) or self-collected vulvo-vaginal swabs (females) for the detection of STIs.

RESULTS

Prevalence of herpes simplex virus type-2 (HSV-2) was 57.8%, syphilis was 1.6%, Neisseria gonorrhoeae was 2.8%, Chlamydia trachomatis was 7.1%, Trichomonas vaginalis was 9.0%, Mycoplasma genitalium was 5.5% and HIV was 36.3%. HIV positive status was associated with an increased probability of having M. genitalium (aPR = 1.49, 95% CI 1.02-2.19) among males and syphilis (aPR = 2.54, 95% CI 1.32-4.86), N. gonorrhoeae (aPR = 2.39, 95% CI 1.62-3.52), T. vaginalis (aPR = 1.70, 95% CI 1.43-2.01) and M. genitalium (aPR = 1.60, 95% CI 1.15-2.22) among females. HIV viral load ≥400 copies per mL was associated with an increased probability of N. gonorrhoeae (aPR = 1.91, 95% CI 1.36-2.70), C. trachomatis (aPR = 1.52, 95% CI 1.12-2.05) and M. genitalium (aPR = 1.83, 95% CI 1.27-2.63).

CONCLUSIONS

The high prevalence of STIs and the association between STIs and HIV, and HIV viral load underscores the public health implications of sustained transmission risk of STIs and HIV. These findings highlight the urgent need for expanding STI surveillance and implementing interventions to monitor and reduce the STI burden.

Authors+Show Affiliations

Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; School of Laboratory Medicine & Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa. Electronic address: Ayesha.kharsany@caprisa.org.Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.Epicentre AIDS Risk Management (Pty) Limited, Cape Town, South Africa.Epicentre AIDS Risk Management (Pty) Limited, Cape Town, South Africa.Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service (NICD/NHLS), Johannesburg, South Africa.Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.Centers for Disease Control and Prevention (CDC), Atlanta, United States.Centers for Disease Control and Prevention (CDC), Atlanta, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32562845

Citation

Kharsany, Ayesha B M., et al. "Population Prevalence of Sexually Transmitted Infections in a High HIV Burden District in KwaZulu-Natal, South Africa: Implications for HIV Epidemic Control." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 98, 2020, pp. 130-137.
Kharsany ABM, McKinnon LR, Lewis L, et al. Population prevalence of sexually transmitted infections in a high HIV burden district in KwaZulu-Natal, South Africa: Implications for HIV epidemic control. Int J Infect Dis. 2020;98:130-137.
Kharsany, A. B. M., McKinnon, L. R., Lewis, L., Cawood, C., Khanyile, D., Maseko, D. V., Goodman, T. C., Beckett, S., Govender, K., George, G., Ayalew, K. A., & Toledo, C. (2020). Population prevalence of sexually transmitted infections in a high HIV burden district in KwaZulu-Natal, South Africa: Implications for HIV epidemic control. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 98, 130-137. https://doi.org/10.1016/j.ijid.2020.06.046
Kharsany ABM, et al. Population Prevalence of Sexually Transmitted Infections in a High HIV Burden District in KwaZulu-Natal, South Africa: Implications for HIV Epidemic Control. Int J Infect Dis. 2020 Jun 17;98:130-137. PubMed PMID: 32562845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Population prevalence of sexually transmitted infections in a high HIV burden district in KwaZulu-Natal, South Africa: Implications for HIV epidemic control. AU - Kharsany,Ayesha B M, AU - McKinnon,Lyle R, AU - Lewis,Lara, AU - Cawood,Cherie, AU - Khanyile,David, AU - Maseko,Domiciled Venessa, AU - Goodman,Tawni C, AU - Beckett,Sean, AU - Govender,Kaymarlin, AU - George,Gavin, AU - Ayalew,Kassahun Abere, AU - Toledo,Carlos, Y1 - 2020/06/17/ PY - 2020/05/03/received PY - 2020/06/12/revised PY - 2020/06/15/accepted PY - 2020/6/21/pubmed PY - 2020/6/21/medline PY - 2020/6/21/entrez KW - HIV KW - HIV viral load KW - Household survey KW - KwaZulu-Natal KW - Population prevalence KW - Sexually transmitted infections KW - South Africa SP - 130 EP - 137 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int. J. Infect. Dis. VL - 98 N2 - BACKGROUND: Sexually transmitted infections (STIs) and Human immunodeficiency virus (HIV) share a complex bidirectional relationship, however, population prevalence and the association between the presence of STIs and HIV in a high HIV burden district in KwaZulu-Natal, South Africa is not known. METHODS: A total of 9812 participants aged 15-49 years were enrolled in a cross-sectional population-based household survey. Participants completed a structured questionnaire and provided first-pass urine (males) or self-collected vulvo-vaginal swabs (females) for the detection of STIs. RESULTS: Prevalence of herpes simplex virus type-2 (HSV-2) was 57.8%, syphilis was 1.6%, Neisseria gonorrhoeae was 2.8%, Chlamydia trachomatis was 7.1%, Trichomonas vaginalis was 9.0%, Mycoplasma genitalium was 5.5% and HIV was 36.3%. HIV positive status was associated with an increased probability of having M. genitalium (aPR = 1.49, 95% CI 1.02-2.19) among males and syphilis (aPR = 2.54, 95% CI 1.32-4.86), N. gonorrhoeae (aPR = 2.39, 95% CI 1.62-3.52), T. vaginalis (aPR = 1.70, 95% CI 1.43-2.01) and M. genitalium (aPR = 1.60, 95% CI 1.15-2.22) among females. HIV viral load ≥400 copies per mL was associated with an increased probability of N. gonorrhoeae (aPR = 1.91, 95% CI 1.36-2.70), C. trachomatis (aPR = 1.52, 95% CI 1.12-2.05) and M. genitalium (aPR = 1.83, 95% CI 1.27-2.63). CONCLUSIONS: The high prevalence of STIs and the association between STIs and HIV, and HIV viral load underscores the public health implications of sustained transmission risk of STIs and HIV. These findings highlight the urgent need for expanding STI surveillance and implementing interventions to monitor and reduce the STI burden. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/32562845/Population_Prevalence_of_sexually_transmitted_infections_in_a_high_HIV_burden_district_in_KwaZulu-Natal,_South_Africa:_Implications_for_HIV_epidemic_control L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(20)30481-1 DB - PRIME DP - Unbound Medicine ER -
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