Background Many studies have shown an association between the presence of a sexually transmitted infection (STI) and the occurrence of HIV infection. Because of improved prognosis and quality of life due to antiretroviral (ARV), people living with HIV (PLHIV) tend to abandon safer sex practices. The consequence could be the resurgence of sexually transmitted infections. The objective of this study is to determine the prevalence of STIs and associated factors in the population of PLHIV in order to lay appropriate prevention strategies.
Methods This is a descriptive cross-sectional study conducted from January to February 2011 on PLHIV admitted in consultation at Centre de Traitement ambulatoire, of academic Hospital of Cotonou. An interrogation and urogenital examination were realised systematically by physicians in all patients. STI diagnosis was presumptive, based on observed lesions. The dependent variable studied is the presence of suggestive lesions of STIs. The data entry was made using Epi Data 3.1 and statistical analysis with SAS version 9.2. Proportions were compared using the χ2 test. The significance level was 5% and CIs at 95%.
Results 85 patients were recruited, 27 (31.76%) had suggestive lesions of STIs. The STIs lesions found in genitals were: irritation (21.18%), papular lesions (12.94%), discharge (10.59%), ulcers (9.41%), and malodorous vaginal discharge (4.71 %). The presumptive diagnosis raised in front of these lesions were: genital candidiasis (23.53%), genital herpes (8.24%), condyloma (3.53%), Chlamydia (2.35%), syphilis (1.18%). STI prevalence was 25% in patients on ARVs as against 52% among untreated OR 0.30 [0.10 to 0.84], p=0.02. The median CD4 count at diagnosis was 379 cells/μl. The majority of patients, that to say 58%, continues to maintain unprotected sex. They were 24% reported having procreated after knowledge of their positive HIV status. This indicates a risk of sexual transmission of infections.
Conclusion STIs are frequent in people with HIV even in patients treated with ARVs. Risk behaviours of STIs and HIV transmission are particularly observed in patients whose clinical and immunological status become satisfying. It appears important to emphasise the observance of security measures in monitoring of patients with HIV, especially when their clinical and immunological status are being improved.
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