Sexual risk behaviour in a cohort of HIV-negative and HIV-positive Rwandan women.

E Bienvenu,G Tobin,O Manzi,M F Mukanyangezi,S Rulisa,D Giglio

doi:10.1017/s0950268818003023

Abstract

Here we wanted to assess whether sexual risk behaviour differs dependent by human immunodeficiency virus (HIV) status by following 100 HIV- and 137 HIV+ women recruited at two university teaching hospitals in Rwanda. Women were tested for sexually transmitted infections (STIs; trichomoniasis, syphilis, hepatitis B and C) and for reproductive tract infections (RTIs; candidiasis, bacterial vaginosis (BV)) and were interviewed at baseline and 9 months later. BV was the most prevalent infection, while syphilis was the most common STI with a 9-month incidence of 10.9% in HIV+ women. Only 24.5% of women positive for any RTI/STI contacted their health facility and got treatment. More HIV- women than HIV+ women had had more than one sexual partner and never used condoms during the follow-up period. The use of condoms was affected neither by marital status nor by concomitant STIs besides HIV. Our data highlight the importance of public education regarding condom use to protect against STIs in an era when HIV no longer is a death sentence.

Highlights

Transmission of sexually transmitted infections (STIs) is a serious health care problem in many countries in Africa [1,2,3]
We showed that human papillomavirus (HPV) infections and other STIs and reproductive tract infections (RTIs) are very common in Rwandan women [14]
More human immunodeficiency virus (HIV)− than HIV+ women, (68.0% vs. 28.5%, respectively; P < 0.001) were married. It was more common among HIV+ women than among HIV− women to have had the sexual debut before the age of 21, to have had more than one lifetime sexual partner and being infected previously by gonorrhoea (21.2% and 6.0%, respectively; P < 0.001; Table 1)

Summary

Introduction

Transmission of sexually transmitted infections (STIs) is a serious health care problem in many countries in Africa [1,2,3]. STIs such as trichomoniasis and syphilis and other reproductive tract infections (RTIs) such as bacterial vaginosis (BV) and candidiasis have been shown to increase the risk of acquiring human immunodeficiency virus (HIV) infection [4,5,6,7]. HIV infection may on the other hand increase the risk of acquiring STIs including human papillomavirus (HPV) [8], syphilis [9], candidiasis [10], herpes [11] and genital ulcer disease [10]. Studies on the prevalence and character of STIs and RTIs in Rwanda are only a few. We showed that HPV infections and other STIs and RTIs are very common in Rwandan women [14]

Methods

Results

Conclusion