Background Bacterial STIs increase mucosal inflammation and HIV acquisition risk. However, most data are limited to symptomatic STIs, and more data are required regarding the prevalence and correlates of asymptomatic bacterial STIs among high-risk young women, and how these vary by exposure to sex work.
Methods We estimated the prevalence of 6 STIs in urine collected during a cross-sectional study of women aged 14–24 years in Mombasa, Kenya (n=870). Participants were recruited from sex work hotspots, and self-identified as engaged or not engaged in formal sex work. STIs including Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), Mycoplasma hominis (MH), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) and Neisseria gonorrhea (NG) were detected using the Seegene Anyplex qPCR panel. The cervicovaginal microbiome and cytokines were also characterized in a subset of 168 participants.
Results The prevalence of any STI was 25.1% (95% CI, 22.3–28.0%). The most common STIs were UU (13.2%) and MH (11.3%), followed by CT (6.6%), TV (3.2%), NG (0.3%), and MG (0.5%). U. urealyticum was more prevalent among sex workers compared to non-sex workers (19.7 vs 10.4%, p=0.001). Number of partners positively correlated with UU (P=0.004), while duration of sexual activity was positively correlated with MH (P<0.001) and UU (P=0.023). Recent history of STI treatment did not correlate with any STI. MH was most associated with symptoms, including vaginal discharge, itching, and painful urination (P< 0.001). All STIs except CT were positively correlated with pro-inflammatory cytokines. UU and MH were correlated with vaginal microbiota alpha diversity (P<0.001).
Conclusion U. urealyticum and M. hominis were the most prevalent STIs among young women from Mombasa, Kenya, and these organisms were associated with sexual exposure and an inflammatory mucosal milieu that has been linked to increased HIV acquisition.
Disclosure No significant relationships.
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