P3-S7.06 Vaginal discharge in women living with HIV attending an AIDS clinic in Manaus, Brazil

Abstract

BackgroundA vaginal discharge and/or vulvar itching and irritation usually characterise Vaginitis, and a vaginal odour might be present. The three diseases most frequently associated with vaginal discharge are BV (replacement of the normal vaginal flora by an overgrowth of anaerobic microorganisms, (Gardnerella vaginalis), trichomoniasis, and candidiasis.ObjectivesTo estimate the prevalence of vaginal discharge in HIV women attending the Institute of Tropical Medicine in Manaus, Amazonas, Brazil.MethodsA cross-sectional study performed among women attending the AIDS clinic from March to December 2010. They were invited to take pat in the study and answered an interview including demographic, behavioural and clinical data. They underwent in a gynaecological examination and it was collect vaginal samples for diagnosingTrichomonas vaginalis, Gardnerella vaginalisandCandida spp.ResultsA total of 338 women were included in the study. Median age was 32 (IQR (IQR): 27; 38) years and median of schooling nine (IQR: 4; 11) years. Prevalence rate of vaginal discharge was 45.8% (95% CI 40.5% to 51.1%). Prevalence ofTrichomonas vaginaliswas 1.2% (95% CI 0.5% to 2.4%),Gardnerella vaginalis35.8% (95% CI 30.7% to 40.9%) and Candidiasis 21.3% (95% CI 16.9% to 25.7%). Median of first sexual intercourse was 16 (IQR: 14; 17) years and 53.6% were married or reported a stable partner. Risk factors reported were: injecting drug use (1.2%), no-injecting drugs (15.2%), previous STI (32.4%), commercial sex workers (16.4%), more than one partner in the last year (12.4%) and in life (94.7%). Regarding clinical symptoms, 50,9% reported chronic pelvic pain, 53.3% vaginal discharge, 47.6% vaginal itching, 22.8% dysuria and 9.5% genital bleeding. CD4 counts were more than 500 cells/mm3in 29.4% and viral load were <1.00 copies/ml in 53.8%. A total of 53.9% of women reporting vaginal discharge had a positive test for at least one disease. In the final model of logistic regression the only variable remained was having viral load <1000 copies/ml decreased the risk of vaginal discharge.ConclusionsRegardless the low cost and large availability of GRAM stain and cytological tests in health services for women with AIDS, there are difficulties which remain to identify interventions that refer to social, cultural and environmental influences on vaginal infections in this group.