Introduction Mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) continues to contribute to HIV incidence across the globe. Research suggests that co-infection with sexually transmitted infections (STIs) Chlamydia trachomatis, Neisseria gonorrhoea, and/or Trichomonas vaginalis may increase the risk of HIV MTCT. This study describes the acceptability and preferences for STI screening among a sample of pregnant, HIV-infected women at two clinics near Pretoria, South Africa.
Methods We approached potentially eligible HIV-infected pregnant women at their first antenatal care visit to invite them to receive STI screening that was integrated into the appointment. Trained staff collected data on STI screening preferences. Following enrollment, women were requested to provide two self-collected vaginal swabs for STI testing (GeneXpert, Cepheid, Sunnyvale, CA, USA).
Results Of the 171 women eligible for enrollment, 168 (98.2%) agreed to participate in the STI study, including STI testing and self-collected vaginal swabs. Of the 167 complete responses, 15.6% (n=26) preferred a urine test for STI screening, 41.1% (n=69) vaginal swab, and 42.9% (n=72) had no preference. Of those who preferred the urine test, the most common reasons were “ease” of the test (n=20, 12.0%), followed by anticipation of the test being “less painful” (n=3, 1.8%), “less uncomfortable” (n=2, 1.2%), “less embarrassing” (n=1, 0.6%), and more familiar (n=1, 0.6%). However, when given directions on the vaginal swab collection procedures, all 168 (100%) women complied and received successful test results.
Conclusion Integration of an STI screening protocol, including self-administered vaginal swabs, into first antenatal care visits appeared to be highly acceptable in this setting among HIV-infected pregnant women. Despite variability in preferences, all women adequately and satisfactorily self-collected vaginal samples, allowing for the timely detection and treatment of infections that may have been otherwise missed.
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