Structure of Gynecological Diseases and Comorbidity in Women with HIV Infection and Reproductive Disorders

Abstract

Background: The increase in the number of HIV-infected women of fertile age, as well as their reproductive plans to have healthy children, was the reason for studying the features of reproductive health disorders and comorbid conditions in women with HIV infection. Methods and Results: Women meeting the inclusion criteria were divided into two groups: Group 1 included 27 HIV-infected women (average age of 30.8±2.9 years) with reproductive disorders; Group 2 included 23 HIV-infected women (average age of 31.4±7.1 years) without reproductive disorders. In study groups, the main route of HIV transmission was sexual contact. When assigning women to a particular category (fertile or infertile), the WHO classification of fertility was used: fertile, presumably fertile, primarily infertile, secondarily infertile, women with unknown fertility. There was a statistically significant difference in the incidence of medical abortion in the HIV-infected women with secondary infertility [14(60.9%)], compared to Group 2 [8(29.6%)] (P=0.026). There were no statistically significant differences in the incidence of chronic co-morbidities (ENT disorders, gastritis/duodenitis, pancreatitis, cystitis, viral hepatitis (B, C), papillomavirus infection) in Groups 1 and 2 (P>0.05). The incidence of pelvic inflammatory diseases was 2 times higher in Group 1 than in Group 2. No statistically significant differences in the incidence of uterine myoma, chronic cervicitis, chronic endometritis, vulvovaginal candidiasis,, and cervical dysplasia were found. A significant prevalence of chronic salpingo-oophoritis, secondary dysmenorrhea, secondary amenorrhea, opsomenorrhea, and secondary oligomenorrhea was detected significantly more frequently in Group 1 than in Group 2. The syndrome of hyperprolactinemia was also 2.6 times more frequent in Group 1 than in Group 2. Reproductive disorders in HIV-infected women were associated with a high incidence of STI combinations (trichomoniasis, gonorrhea, syphilis, chlamydia). Conclusion: Early detection of menstrual dysfunctions, prevention of abortion and sexually transmitted diseases, and timely treatment of infertility, are essential for women living with HIV.