Abstract

BackgroundWomen living with HIV/AIDS (WLHA) are a high risk group for sexually transmitted infections (STIs). However, the majority of women with STIs are asymptomatic. Data on prevalence of STIs among WLHA in Uganda are limited. The objective of the study was to determine prevalence and factors associated with STIs among WLHA opting for intrauterine contraceptive device (IUD).MethodsThree hundred fifty one WLHA deemed free of STIs using a syndromic logarithm were enrolled into the study. Endo-cervical swabs were taken before IUD insertion and PCR test for Nisseria gonorrhea (NG), Trichomonas vaginalis (TV) and Chlamydia trachomatis (CT) infections conducted.ResultsParticipants’ mean age was 29.4 ± 6.2 years, 83% were under 35years, 50% had secondary education and 73% were married. The majority (69%) had disclosed their HIV sero status to their spouses, 82% used Cotrimoxazole prophylaxis, 70% were on antiretroviral therapy, 90% had CD4 count greater than 350, about 60% reported condoms use and 70% were of parity 2-4. Over 50% of the participants’ spouses were older than 35 years and 72% had attained secondary education. STIs prevalence was 11.1%, (95% CI 7.8-14.4) and individual prevalence for TV, NG, and CT was 5.9%, 5.4% and 0.9% respectively. Factors independently associated with STI were having primary or less education (OR= 2.3, 95% CI: 1.09 - 4.85) having a spouse of primary or less education (OR= 3.3, 95% CI: 1.6 - 6.78) and muslim faith (OR= 0.2, 95% CI: 0.04 - 0.78).ConclusionSTI prevalence was 11.1%. TV and NG were the commonest STIs in this population. Having primary or less education for both participant and spouse was associated with increased risk while being of muslim faith was associated with reduced risk of STI.

Highlights

  • Transmitted infections (STIs) remain a global public health challenge

  • Endo-cervical swabs were taken before intrauterine contraceptive device (IUD) insertion and PCR test for Nisseria gonorrhea (NG), Trichomonas vaginalis (TV) and Chlamydia trachomatis (CT) infections conducted

  • STIs prevalence was 11.1%, and individual prevalence for TV, Neisseria gonorrhea (NG), and CT was 5.9%, 5.4% and 0.9% respectively

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Summary

Introduction

Transmitted infections (STIs) remain a global public health challenge. The latest World Health Organization estimates indicate that 498.9 million new STIs occur annually among people aged between 15 and 49 years [1]. Sub Saharan Africa has an STI incidence of 240/1000 which is the highest in the world [1]. It is estimated that 8.3, 21.1 and 59.7 million new cases of Chlamydia trachomatis (CT), Neisseria gonorrhea (NG) and Trichomonas vaginalis (TV) infections take place in sub Saharan Africa annually [1]. Women living with HIV/AIDS (WLHA) are a high risk group for sexually transmitted infections (STIs). Data on prevalence of STIs among WLHA in Uganda are limited. The objective of the study was to determine prevalence and factors associated with STIs among WLHA opting for intrauterine contraceptive device (IUD)

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