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O10 – GETTING REAL WITH IMPLEMENTING PREP 2
Tuesday, July 16, 2019 4:15 PM – 5:45 PM
O10.3 High curable STI prevalence and incidence among young african women initiating PrEP in HPTN 082
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  1. Sinead Delany-Moretlwe1,
  2. Nyaradzo Mgodi2,
  3. Linda-Gail Bekker3,
  4. Jared Baeten4,
  5. Subash Pathak5,
  6. Deborah Donnell5,
  7. Denni Lennon6,
  8. Scott Rose7,
  9. Keolopile Makgamathe1,
  10. Sheetal Kassim8,
  11. Shorai Mukaka2,
  12. Heather Noble5,
  13. Adeola Adeyeye9,
  14. Connie Celum10
  1. 1University of the Witwatersrand, Wits RHI, Johannesburg, South Africa
  2. 2University of Zimbabwe,, College of Health Sciences Clinical Trials Unit, Harare, Zimbabwe
  3. 3University of Cape Town, Infectious Diseases, Cape Town, South Africa
  4. 4University of Washington, Medicine, Global Health, Epidemiology, Seattle, USA
  5. 5Fred Hutchison Cancer Research Centre, Scharp, Seattle, USA
  6. 6Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, USA
  7. 7FHI 360, 8fhi 360, HIV Prevention Trials Network, Durham, USA
  8. 8The Desmond Tutu HIV Centre, Cape Town, South Africa
  9. 9National Institutes of Allergy and Infectious Diseases, Division of AIDS, Rockville, USA
  10. 10University of Washington, Seattle, USA

Abstract

Background African women face overlapping HIV and STI risks. PrEP programs among men who have sex with men have seen high STI incidence, but few data from African women taking PrEP are available

Methods HPTN 082 was conducted in Cape Town, Johannesburg (South Africa) and Harare (Zimbabwe) to evaluate uptake and adherence to daily oral PrEP in young African women. Sexually active HIV-negative women ages 16–25 were enrolled. Enrollment vaginal swabs were tested for gonorrhea (GC) and chlamydia (CT) by nucleic acid amplification, and trichomonas (TV) by rapid test. Syphilis serology was assessed. All women with positive test results received treatment. Repeat testing was conducted at 6 and 12 months.

Results Of the 412 women who initiated PrEP, median age was 21 years, 84% reported a primary sex partner and a median of 4 vaginal sex acts (IQR 2,8) in the prior month; 35% reported that they never or rarely used condoms. At enrollment 29% of women had CT, 8% GC, 7% TV and 2% reactive syphilis serology. STI incidence was 29.6 per 100 person-years (py) for CT (95% CI 24.3, 35.4), 11.8 per 100 py for GC (95% CI 8.7, 15.7), and 7.1 per 100 py for TV (95% CI 4.7, 10.2). The majority of incident STIs were new infections: 79 of 119 CT infections, 41 of 48 GC infections, and 23 of 29 TV infections diagnosed were in women who did not have these infections at enrollment. The majority of these infections were asymptomatic.

Conclusion The prevalence and incidence of treatable STIs were high among young African women initiating PrEP. Diagnostic STI testing is important and innovative strategies that reduce STI acquisition, complications, and their potential impact on future fertility, need evaluation within the context of PrEP services where currently syndromic STI management is the standard of care.

Disclosure No significant relationships.

  • PrEP

https://doi.org/10.1136/sextrans-2019-sti.160

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