Treatment Of Reproductive Tract Infections Research Articles

Prevelence and Incedence of Reproductive Tract Infections Among Married Women in India

Reproductive tract infections (RTI) are the infections which affects any organ related to genital tract. Reproductive tract infections are also known to act one of the risk factor for transmission of HIV, and are common yet neglected health problem affecting health and social wellbeing of women in their most productive age. The annual incidence of Reproductive tract infections and sexually transmitted infections in India is estimated at 5% or approximately 40 million every year. Although early detection and treatment of Reproductive tract infections can prevent complications and minimize the severity of long-term sequels, still RTI remains undiagnosed and untreated. Reproductive tract infections may also present as symptomatic among women who cause wide spread of disease in the community and also responsible for severe morbidity. Women show less interest on health seeking and have minimal knowledge on RTI/STI. This article provides a summary overview based on the data related to literature shows that age group of women, education, occupation, and standard of living were major factors affecting awareness on reproductive tract infections. Women who were illiterates do not seek treatment due to existing inhibitions regarding reproductive health; need targeted interventions for reproductive health messages. Need to make them aware of simple and the best confirmatory evidence of reproductive tract infections.

Impact of community strategy package on uptake of reproductive tract infections health services among young street females in the municipality of Eldoret, Kenya

BackgroundDespite the intervention of free medical care services for street children by a dedicated clinic in Eldoret municipality, health care service of young street females (YSFs) is still deficient. The...

Prevalence of reproductive tract infections among women preparing to conceive in Chongqing, China: trends and risk factors

BackgroundReproductive tract infection has become a major public health issue all over the world for its high and growing prevalence. It can cause adverse pregnancy outcomes in pregnant women and their foetuses. This study aimed to investigate the trends and risk factors of the prevalence of reproductive tract infections among women who prepared to conceive in the Chongqing Municipality (China) from 2012 to 2016.MethodsA multi-center cross-sectional study was conducted between January 2012 and December 2016. Women aged 20–49 years who intended to get pregnant were recruited for this study. All participants underwent preconception examination, which included testing for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, syphilis, bacterial vaginosis and candidiasis according to the national diagnostic standard. A total of 439,372 women with testing results for all six types of reproductive tract infections were included in our final analyses. Logistic regression and factor analysis were used to determine the possible sociodemographic factors associated with prevalence trends.ResultsIn our study, the overall positive rate of RTIs among the 439,372 women of reproductive age was 5.03%. Candidiasis was the most common infection in our population (2.47%), followed by bacterial vaginosis (1.28%), syphilis (0.73%), T. vaginalis (0.49%), C. trachomatis (0.20%) and N. gonorrhoeae (0.06%). The prevalence of reproductive tract infections was highest among women aged 35 years and above, with a primary or lower education level, history of pregnancy, delivery, induced abortion, or spontaneous abortion. From 2012 to 2016, the trend of the overall prevalence of reproductive tract infections was V-shaped, decreasing steadily from 2012 to 2015, with a slight rise in 2016. Our results suggest that the distribution change of age, education level, gravidity, parity, and history of induced abortion influenced this trend.ConclusionSince the number of high-risk women who intend to become pregnant is growing in the Chongqing Municipality, pre-conception positive preventions including health education, regular screening, and timely treatment of reproductive tract infections are needed to prevent the impact of reproductive tract infections on maternal health and infant safety.

Etiopathogenesis of reproductive tract infections and the emerging role of bitter taste receptors: A scoping review

Reproductive tract infections pose an immense public health concern worldwide as over 600 million new cases are recorded annually along with several complications, including infertility, ectopic pregnancy, preterm delivery, and neonatal death. Despite improved understanding of the mechanisms of pathogenic invasion, the etiopathogenesis of reproductive tract infections is yet to be completely understood. Recent data has suggested a critical role of bitter taste receptors of the reproductive tract in etiopathogenesis of reproductive tract infections. Here, we review the literature on current etiopathogenesis of reproductive tract infections and the role of bitter taste receptors of the reproductive tract in etiopathogenesis of reproductive tract infections. Emerging evidence suggests a critical role of microbiota disorder of the reproductive tract in reproductive tract infections. Several bacterial, protozoan parasitic, helminthic parasitic and viral pathogens have been identified as causative agents of reproductive tract infections. These pathogens subvert host defenses and activate specific architectural units of the uroepithelium such as Toll-like receptors, which recognize conserved motifs on the pathogens. The activated Toll-like receptors mediate downstream signaling, stimulating nuclear factor-κB, which in turn activates the production of proinflammatory cytokines. This pathway is also associated with recruitment of immunocytes to the site of aggression and release of proteinases, which drive tissue damage in the reproductive tract. Defects in detection of pathogenic components by the bitter taste receptors of the reproductive tract may play a critical role in the etiopathogenesis of reproductive tract infections. This review provides important information for identification of novel frontiers for the treatment of reproductive tract infections.

Training of women self-help groups against reproductive tract infections - A pilot study

Reproductive tract infections (RTIs) are silent epidemics and put a heavy toll on women in developing countries. Women, because of their ignorance and socio-cultural inhibitions, hardly seek treatment for RTIs. Women self-help groups (SHGs) if adequately trained, can play an active role in creating awareness and promote healthy behaviours among women. The present study aimed to evaluate the Effectiveness of STAR (Self-help group Training to Alleviate Reproductive tract infection) program on knowledge, practices, skills and health-seeking behaviours on RTIs among self-help group women in the reproductive age group. A quasi-experimental (non-equivalent control group) study with repeated follow-up was done among 63 women belonging to the selected SHG units. Women in the intervention group (n=33) underwent a training program on RTIs and had regular monthly follow-up for 6months, and the comparison group (n=30) only had a routine follow-up. Post-test observations were conducted at the end of three months and six months. The data were analyzed using repeated-measures ANOVA using SPSS package version 16. There was a significant difference in the knowledge, practice, skill and health-seeking behaviour scores at different points of time (P<0.001). However, the between-group pairwise comparison revealed that the training program was effective in improving the mean knowledge (P=0.001), skill (P=0.014) and health-seeking behaviour (P=0.034) scores and had no effect on the practice score (P=0.74). The STAR program was found to be effective in improving the knowledge, skill and health-seeking behaviours of the self-help group women.

“Livelihoods and health hazards: With special reference to reproductive health of rural women

Health is considered as a fundamental human right. It is a country where 68.80% of the population resides in a rural area and males significantly outnumber females. Health is considered as a fundamental human right. Health of women is not merely a state of physical well being but also an expression of many roles they play as wives, mothers, health care providers in the family and in the changed scenario even as wage earners. Reproductive health implies that people including men and women are able to have a satisfying safe sex life and they have the capability to reproduce and the freedom to decide if, when and how often to do so. It includes family planning services, access to contraception, counseling and information, antenatal, postnatal and delivery care, healthcare for infants, treatment for reproductive tract infections and sexually transmitted diseases, safe abortion services where legal and management of abortion related complications, prevention and appropriate treatment for infertility, information, education and counseling on human sexuality, reproductive health and responsible parenting and discouragement of harmful practices. Health plays important role in the generation of livelihoods of rural people in general and women in particular. Reproductive Health of women is neglected area and new reproductive health problems are increasing such as infection in uterus, breast cancer, and sexually transmitted disease. Well being of reproductive health of rural women enhances the chances of livelihood of rural women. The present study addresses all the issues concerning with livelihoods and reproductive health and this study was carried in Solapur and Kolhapur districts of Western Maharashtra. The objectives of study are to understand the socio-economic background of selected rural women for proposed project and to know the issues related rural women's reproductive health and availability of reproductive health care in rural areas. 200 married women respondents in age group of 18–25 were selected for study. Still fifty percentage of rural women are only unaware about the reproductive health and gender discrimination should be addressed and it is necessary to create the awareness about reproductive health among males

Frequency and determinants of health care utilization for symptomatic reproductive tract infections in rural Indian women: A cross-sectional study.

IntroductionThe public health burden of reproductive tract infections (RTIs) among women in rural areas of low-income countries is poorly addressed because health care seeking for treatment of RTIs is inadequate. There are gaps in knowledge about whether low care seeking behavior stems from challenges in accessing health care versus women's recognition of and response to RTI-specific disease symptoms. We aim to identify determinants of care seeking behavior and analyze the difference in utilization of health care resources in response to symptoms of an RTI versus non-RTI disease symptoms in rural India. This will aid in the design of interventions that promote RTI care seeking behavior.MethodsOur analysis uses data from a cross-sectional, population-based surveillance survey among rural, non-pregnant women in Odisha, India, from 2013–2014 (n = 3,600). We utilized bivariate logistic regression to determine the degree that certain determinants are associated with a woman’s likelihood to seek RTI treatment, and chi-Squared tests to assess for differences in health care resources used for non-RTI versus RTI symptoms.ResultsMarried women were significantly more likely to seek health care for RTI symptoms (Odds Ratio (OR) = 1.9, 95% Confidence Interval (CI): 1.2–3.0) while unmarried adolescents were less likely to seek treatment (OR = 0.4, CI: 0.2–0.6). There was no association between RTI health care seeking with education level, belief about whether symptoms can be treated, or poverty. The majority (73.8%) of women who did not seek treatment for RTI symptoms reported not seeking treatment because they did not know treatment was needed. Women utilized formal health care providers at a higher rate in response to RTI symptoms than in response to their most recent symptoms of any kind (p = 0.003).ConclusionsCommunity-based reproductive health education interventions are needed to increase health care seeking behavior for RTIs in rural Indian women. Interventions should target unmarried women and focus on both sexual health education and access to care.

Role for the mammalian female reproductive tract microbiome in pregnancy outcomes.

Since the discovery of the microbiome in humans, it has been studied in many mammalian species. Different microbiological communities with variable richness and diversity have been found among these species in distinct areas of the reproductive tract. Human studies have shown that the composition of the microbiome is dependent on body site and several host-related factors. Furthermore, specific phyla have been identified among the different species and within distinct areas of the female reproductive tract, but a "core" microbiome of the female reproductive tract has not been defined in any species. Moreover, the function of the microbiome in the reproductive tract is not yet fully understood. However, it has been suggested that a change in diversity of the microbiome and the presence or absence of specific microbial species might be useful indicators of pregnancy outcomes. Increased comprehensive knowledge of the microbiological communities in the female reproductive tract is needed since adverse outcomes represent a significant problem to many species, including livestock, exotic or endangered species, and humans. To the authors' knowledge, a review combining current female reproductive tract microbiome data among different mammalian species has not been published yet. Herein is a comprehensive review of what is known in the field of the female reproductive microbiome and how it correlates with reproductive success or failure in mammals. Further studies may lead to optimization of therapies in the treatment of reproductive tract infections and pregnancy failure, and may create opportunities for novel approaches for improving reproductive efficiency in animals and people.

Knowledge about reproductive tract infections and sex work among female textile workers in Surat, India

In this qualitative study, we investigated knowledge about reproductive tract infections (RTIs) and commercial sex work among female textile workers of Surat, India. We analyzed data from three focus groups conducted with 18 women using content analysis. Participants had some knowledge about the symptoms of RTIs; however, they had limited knowledge about RTI prevention, transmission, and treatment. None used condoms consistently for RTI prevention. The women attributed economic hardship as one of the main reasons for engaging in commercial sex work. Our study is one of the first to evaluate sexual and reproductive health among female textile workers in India.

Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities

Background: Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. Trained nurses provide fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment of reproductive tract infections (RTI) and refer for further tests and treatment indicated. Methods: We retrospectively reviewed and analyzed WHP medical records from women who presented for cervical cancer screening from 2007-2014. Results: In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment of RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. Conclusion: The WHP's experience using a cost-recovery model and offering multiple services in a single clinic rather than stand-alone cervical cancer screening may be a practical model to make cervical cancer screening services accessible, comprehensive and sustainable. Integrating other women's health services enabled women to address additional health care needs.

The association between voucher scheme and maternal healthcare services among the rural women in Bangladesh: a cross sectional study

Background: Maternal health voucher scheme, providing financial support to poor women, is popularly known as subsidies in maternity care services including antenatal, delivery and postnatal care and also economic barriers while seeking treatment from qualified service providers. The aim of this study is to evaluate the association of voucher scheme on receiving maternal healthcare services among the rural women in Bangladesh.Methods: This is a cross sectional study where total sample size was (n=500) rural women who were selected by using convenience sampling method. Among them, 250 women were voucher scheme receivers and other 250 women were non-voucher scheme receivers. A structured questionnaire was adopted for data collection between November and December 2015. In the final analysis, cross tabular analysis and logistic regression model were used, and adjusted odds ratios (ORs) were reported.Results: The study found a strong relation between voucher scheme and maternal healthcare services among the rural women in Bangladesh where majority (88.4%) voucher scheme receivers received information or treatment of Reproductive Tract Infections (RTIs) and Sexually Transmitted Infections (STIs) while non-voucher scheme receivers received only 10%. Most of the respondents (93%) voucher scheme receivers received at least 3 times of antenatal care visit; but only 28% received non-voucher scheme receivers at least 3 times of antenatal care visit. Voucher scheme receivers received 17.127 times more likelihood to receive skilled birth attendance and 25.344 times more likelihood to receive institutional delivery services and positively significant (5 percent) compared to those who did not receive maternal heath voucher scheme. Moreover, 92.4% voucher receivers received transport cost and 73.2%, received safe home delivery services while 22.8% non-voucher scheme receivers received transport cost and only 20.4% received safe home delivery services. Majority (94%) voucher scheme receivers received long time birth control services while only 19.2% non-voucher scheme receivers received long time birth control services.Conclusion: Women who did not receive maternal health voucher scheme found the status of lower antenatal, delivery and postnatal care services receiving trends compared to the women who received the maternal health voucher scheme. It is recommended an effective monitoring system and necessary interventions getting overall developed health status in Bangladesh.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.545-555

Prevalence and awareness of reproductive tract infections among women in select underprivileged areas of Bangalore city

Background: Reproductive tract infections (RTIs) and sexually transmitted infections (STIs) present a huge burden of disease and adversely impact reproductive health of people. They are more common in developing countries than developed. Objective: (1) To study the awareness, prevalence, and factors associated with RTIs among women aged 15–49 years residing in two slum areas of Bangalore city. (2) To assess the treatment seeking behavior for symptoms suggestive of RTIs in the past 1 year. Materials and Methods: Using systematic random sampling, 470 women of age group 15–49 years were studied from June 2010 to September 2011. Data were collected using a structured pretested questionnaire at their houses. Result: A total of 29.15% women had symptom suggestive of RTIs. White discharge was reported by 17.45%, genital skin infections by 14.47%, lower abdominal pain by 9.15%, complain of genital ulcer reported in 0.21%, and none complained of inguinal bubo. Symptoms of RTI were higher in young, Muslim women, those with higher education and poor menstrual hygiene. Only 62 (45.25%) symptomatic women had sought some form of treatment. Private doctors were preferred by 87% of women who sought treatment and only 6.7% went to government doctors. None had adequate knowledge regarding RTIs and 324 (68.93%) women had some knowledge. Conclusion: About one-third of the women had experienced at least one symptom of RTI in the past 1 year. Women in reproductive age group showed very poor awareness regarding RTI and poor treatment seeking behavior for the same.

Comparative study of reproductive tract infections of female sex workers and gynecology clinic patients and general population in Suzhou

Background : Reproductive tract infections (RTIs) have become international public health problem. Aim : We assessed the RTIs. A community-based study was carried out among female sex workers (FSWs), gynecology clinic patients and general population in Suzhou, China to investigate the major pathogens of RTIs and to compare the pathogens among FSWs, gynecology clinic patients and general population. Materials and methods : The study was conducted over 12 months in 1357 women. They were recruited into three groups: group I: 243 asymptomatic FSWs, group II: 629 symptomatic gynecology clinic patients, and group III: 485 women who attending physical examination. The collection of genital specimens was performed after informed and written consent was obtained. All specimens were transported to department of clinical laboratory and processed by standard methods. Laboratory reports were sent to the clinicians and appropriate treatment was instituted. Data were analyzed by statistical methods. Results : Overall, 110 out of 243 asymptomatic FSWs were detected with pathogens, equaling 45.27% showing positive, while 301 out of 629 symptomatic gynecology clinic patients were detected with pathogens, 9.27% general population were detected with pathogens. Reproductive tract infections (RTIs) were more prevalent in FSWs than general population. The distribution of pathogens among three groups was different. Conclusion : Rates of RTIs are still high among FSWs in Suzhou. Where resources allow, routine screening and treatment of RTIs should be offered. The study also highlights that health intervention measures directed towards reducing morbidities from RTIs need not focus mainly on treatment of RTIs but rather on disease preventing strategies. Keywords : Female sex workers, reproductive tract infections, pathogens, distribution

Correlates of HIV-1 Genital Shedding in Tanzanian Women

BackgroundUnderstanding the correlates of HIV shedding is important to inform strategies to reduce HIV infectiousness. We examined correlates of genital HIV-1 RNA in women who were seropositive for both herpes simplex virus (HSV)-2 and HIV-1 and who were enrolled in a randomised controlled trial of HSV suppressive therapy (aciclovir 400 mg b.i.d vs. placebo) in Tanzania.MethodologySamples, including a cervico-vaginal lavage, were collected and tested for genital HIV-1 and HSV and reproductive tract infections (RTIs) at randomisation and 6, 12 and 24 months follow-up. Data from all women at randomisation and women in the placebo arm during follow-up were analysed using generalised estimating equations to determine the correlates of cervico-vaginal HIV-1 RNA detection and load.Principal FindingsCervico-vaginal HIV-1 RNA was detected at 52.0% of 971 visits among 482 women, and was independently associated with plasma viral load, presence of genital ulcers, pregnancy, bloody cervical or vaginal discharge, abnormal vaginal discharge, cervical ectopy, Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, an intermediate bacterial vaginosis score and HSV DNA detection. Similar factors were associated with genital HIV-1 RNA load.ConclusionsRTIs were associated with increased presence and quantity of genital HIV-1 RNA in this population. These results highlight the importance of integrating effective RTI treatment into HIV care services.

Characterization of low molecular weight antimicrobial peptide from human female reproductive tract

Background & objectives:The mechanisms that protect female upper genital tract from ascending infection by microbes present in vagina are only partially understood. It is expected that epithelial cells in mucosal surfaces and their secretions directly interfere with microbial colonization and invasion. This study was aimed to demonstrate the expression of 2 kDa antimicrobial peptide which was identified and purified from female genital tract tissues using chromatographic techniques.Methods:Low molecular weight proteins were isolated from human female reproductive tract tissues obtained from premenopausal women. Antimicrobial activity of these LMW proteins was assessed against different reproductive tract pathogens viz., Neisseria gonorrhoeae, Group B streptococcus, Gardnerella vaginalis, Escherechia coli and Candida albicans. The expression of these peptides were also documented in reproductive tract tissues with the help of hyperimmune sera raised against the rabbits. The purified peptide was characterized by N-terminal sequencing.Results:Immunohistochemical and immunofluorescence studies demonstrated that 2 kDa peptide was expressed in the stratified squamous epithelial cells of the ectocervix while it was absent in columnar epithelial cells of upper genital tract. Upregulation of the expression of this peptide was observed in patients of chronic non-specific cervicitis and acute on chronic cervicitis. This purified antimicrobial peptide also showed broad spectrum antimicrobial activity against different reproductive tract pathogens.Interpretation & conclusions:Considering the emerging bacterial resistance against conventional antibiotics, isolation and understanding of the expression of antimicrobial peptides from female reproductive tissue extracts may provide some leads towards the development of strategies for the treatment of reproductive tract infections.

Maternal morbidity in the first year after childbirth in Mombasa Kenya; a needs assessment

BackgroundIn sub-Saharan Africa, few services specifically address the needs of women in the first year after childbirth. By assessing the health status of women in this period, key interventions to improve maternal health could be identified. There is an underutilised opportunity to include these interventions within the package of services provided for woman-child pairs attending child-health clinics.MethodsThis needs assessment entailed a cross-sectional survey with 500 women attending a child-health clinic at the provincial hospital in Mombasa, Kenya. A structured questionnaire, clinical examination, and collection of blood, urine, cervical swabs and Pap smear were done. Women's health care needs were compared between the early (four weeks to two months after childbirth), middle (two to six months) and late periods (six to twelve months) since childbirth.ResultsMore than one third of women had an unmet need for contraception (39%, 187/475). Compared with other time intervals, women in the late period had more general health symptoms such as abdominal pain, fever and depression, but fewer urinary or breast problems. Over 50% of women in each period had anaemia (Hb <11 g/l; 265/489), with even higher levels of anaemia in those who had a caesarean section or had not received iron supplementation during pregnancy. Bacterial vaginosis was present in 32% (141/447) of women, while 1% (5/495) had syphilis, 8% (35/454) Trichomonas vaginalis and 11% (54/496) HIV infection.ConclusionThroughout the first year after childbirth, women had high levels of morbidity. Interface with health workers at child health clinics should be used for treatment of anaemia, screening and treatment of reproductive tract infections, and provision of family planning counselling and contraception. Providing these services during visits to child health clinics, which have high coverage both early and late in the year after childbirth, could make an important contribution towards improving women's health.

Reproductive Tract Infections in Northern Vietnam: Health Providers' Diagnostic Dilemmas

Research was conducted on reproductive tract infections among women obtaining induced abortions at Phụ-Sản hospital in Haiphong City, a major maternity hospital in northern Vietnam. The research aimed to explore how clinicians and lab-technicians diagnose reproductive tract infections and the difficulties they experience in establishing exact diagnoses. A combination of both quantitative and qualitative research methodologies was employed. The quantitative research involved 748 abortion-seeking women; the qualitative research was conducted with 10 doctors and 10 lab-technicians providing reproductive health services. A marked tendency was observed among both clinicians and lab-technicians to overdiagnose reproductive tract infections and to prescribe antibiotics routinely. Social, cultural, and clinical factors associated with the tendency to overdiagnose reproductive tract infections included: inadequate training of health staff, lack of equipment, and cultural assumptions regarding the overwhelming prevalence of reproductive tract infections in Vietnamese women, especially among those who receive abortion services. Misconceptions of reproductive tract infections led to substantial over-diagnosis and unnecessary treatment of reproductive tract infections in this hospital. To enhance reproductive tract infection care, providers need to be sensitized to the social and medical consequences of their own cultural perceptions and to increase their awareness of the risks associated with overuse of antibiotics.

Disentangling Contributions of Reproductive Tract Infections to HIV Acquisition in African Women

: To estimate the effects of reproductive tract infections (RTIs) on HIV acquisition among Zimbabwean and Ugandan women. : A multicenter prospective observational cohort study enrolled 4439 HIV-uninfected women aged 18 to 35 attending family planning clinics in Zimbabwe and Uganda. Participants were interviewed, and tested for HIV and RTIs every 3 months for 15 to 24 months. They received HIV risk reduction counseling, male condoms, and treatment for curable RTIs. : Despite HIV risk reduction counseling and regular screening and treatment for RTIs, the HIV incidence did not decline during the study. Positive HSV-2 serostatus at baseline (hazard ratio [HR] = 3.69, 95% confidence interval = 2.45-5.55), incident HSV-2 (HR = 5.35, 3.06-9.36), incident Neisseria gonorrhoeae (HR = 5.46, 3.41-8.75), and altered vaginal flora during the study (bacterial vaginosis [BV]: HR = 2.12, 1.50-3.01; and intermediate flora: HR = 2.02, 1.39-2.95) were independently associated with HIV acquisition after controlling for demographic and behavioral covariates and other RTIs (Treponema pallidum, Chlamydia trachomatis, Trichomonas vaginalis, and vaginal yeasts). For N. gonorrhoeae, C. trachomatis, T. vaginalis, and vaginal yeasts, the risk of HIV acquisition increased when the infection was identified at the visit before the HIV-detection visit or with the duration of infection. Population attributable risk percent (PAR%) calculations show that HSV-2 contributes most to acquisition of new HIV infections (50.4% for baseline HSV-2 and 7.9% for incident HSV-2), followed by altered vaginal flora (17.2% for bacterial vaginosis and 11.8% for intermediate flora). : A substantial proportion of new HIV infections in Zimbabwean and Ugandan women are attributable to RTIs, particularly HSV-2 and altered vaginal flora.

Riddle of the Sphinx Revisited: The Role of STDs in HIV Prevention

Riddle of the Sphinx Revisited: The Role of STDs in HIV Prevention

WOMEN'S REPRODUCTIVE MORBIDITY AND TREATMENT-SEEKING BEHAVIOUR IN INDIA

The study highlights net effects of selected socio-economic, demographic and cultural factors on the prevalence and treatment-seeking behaviour for reproductive morbidity in India on the basis of self-reported reproductive health problems elicited from 84,862 currently married women aged 15–49 in the second National Family Health Survey, 1998–1999 (NFHS-2). Information was elicited on treatment sought, if any, from private or public health service providers from 34,034 women suffering from reproductive tract infections (RTIs). The study employed binary and multinomial logit regression techniques for respectively analysing prevalence and treatment-seeking behaviour. The prevalence of RTIs in India is quite high (40 per cent) and the treatment-seeking is extremely low (33 per cent). Usage of female sterilization and Intra-Uterine Device (IUD) significantly compounds the reproductive morbidity in India, possibly because of negligence in post-operative or post-insertion care. Women suffering from abdominal pain or intercourse-related complications have a higher likelihood of seeking treatment for RTIs.