Article Text
Abstract
Introduction Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) cause infections in the female genital tract, increasing susceptibility to and infectiousness of HIV. Our objectives were to determine prevalence and associated factors of CT and GC among HIV-infected women in Brazil.
Methods Cross-sectional study, including HIV-infected women attending nine referral centres in nine states of Brazil, aged 18 to 49 years, not pregnant. An interview was conducted including sociodemographic, epidemiological and clinical characteristics. After the interview, gynaecological examination was conducted to collect cervical cytology and vaginal secretion to Chlamydia trachomatis, Neisseria gonorrhoeae and HPV tests through molecular biology.
Results A total of 802 (89.1%) women participated. The prevalence of CT was 17 cases (2.1%) and GC was 7 cases (0.9%). The prevalence of a positive test for both CT and/or GC was 2.7%. The factors associated with positive CT/GC test in the multivariate logistic regression analysis were abnormal papanicolau smear [OR 4.1 (95% CI:1.54–11.09)] and the presence of abnormal cervical discharge [OR=2.6 (95%CI:1.02–6.71)]. Among the 377 women that reported previous STI: 245 (65.0%) reported using condom more frequently after being diagnosed. Regarding how they discovered the STI, 62 (16.4%) the partner told he was infected by an STI; 157 (41.6%) had STI symptoms and looked for care and 158 (41.9%) discovered it in a routine consultation for another reason.
Conclusions The control of STI represents a unique opportunity to improve reproductive health of women living with HIV. This diagnostic can change their behaviour and reduce the sexual transmission of HIV and bacterial STI. Controlling STI and identifying factors associated with such diseases continues to be an important element in the design of interventions targeting STI and as a result, HIV prevention in Brazil.
Support: Technical cooperation agreement, Brazilian Department of STI, AIDS and viral hepatitis, Ministry of Health and United Nations office for drugs and crime. Project BRA/K57, process #01/2013