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Neisseria gonorrhoeae and Chlamydia trachomatis infection in HIV-1-infected women taking antiretroviral therapy: a prospective cohort study from Burkina Faso
  1. Andrea J Low1,
  2. Issouf Konate2,
  3. Nicolas Nagot2,3,
  4. Helen A Weiss1,
  5. David Mabey1,
  6. Michel Segondy3,
  7. Peter Vickerman1,
  8. Nicolas Meda2,
  9. Philippe van de Perre2,3,
  10. Philippe Mayaud1,
  11. for the Yerelon Cohort study group
  1. 1Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Unité de Recherche Santé de la Reproduction, VIH et Maladies Associées, Centre Muraz, Bobo-Dioulasso, Burkina Faso
  3. 3Departement de l'Information Medicale et Bacterologie-Virologie, INSERM U1058 Universite Montpellier-1 & CHU Montpellier, Montpellier, France
  1. Correspondence to Dr Andrea Low, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; andrea_low{at}hotmail.com

Abstract

Objectives Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) are common sexually transmitted infections (STI). We assessed the cumulative risk of NG and CT in a cohort of HIV-1-infected high-risk women taking antiretrovirals over 4 years in Burkina Faso.

Methods Between March 2007 and February 2011, participants were followed every 3–6 months. At each visit, participants underwent a gynaecological examination with collection of cervical and vaginal swabs. Random-effects logistic regression models were used to analyse associations of NG and CT infection with behavioural and biological factors.

Results 172 women had samples tested for NG and CT during the study period, in a total of 1135 visits. NG was detected in 6.4% of women (11/172, 95% CI 2.7 to 10.1) at a rate of 2.76 cases (95% CI 1.53 to 4.99) per 100 person-years. CT was detected in 1.7% (3/172, 95% CI 0 to 3.7) of women at a rate of 0.75 cases (95% CI 0.24 to 2.34) per 100 person-years. The majority of women were asymptomatic (9/14). In the multivariable model, the presence of NG or CT was associated with tobacco use (aOR=11.85, 95% CI 1.13 to 124.17), and concurrent genital HIV-1 RNA shedding (aOR=4.78, 95% CI 1.17 to 19.46). Higher levels of education (aOR=0.17, 95% CI 0.03 to 0.92), and age greater than 35 years (aOR=0.07, 95% CI 0.01 to 0.92) were associated with lower odds of infection.

Conclusions The risk of NG or CT infection remains low among high-risk women in Bobo-Dioulasso. This provides some evidence that antiretroviral use does not contribute to behavioural disinhibition. The asymptomatic nature of most infections underscores the need for regular screening and treatment of STIs in core groups.

  • Africa
  • Anteretroviral Therapy
  • Chlamydia Infection
  • Gonorrhoea
  • HIV

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/

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  • Abstract in French

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