PT - JOURNAL ARTICLE AU - Judith Vandepitte AU - Helen A Weiss AU - Justine Bukenya AU - Nassim Kyakuwa AU - Etienne Muller AU - Anne Buvé AU - Patrick Van der Stuyft AU - Richard J Hayes AU - Heiner Grosskurth TI - Association between <em>Mycoplasma genitalium</em> infection and HIV acquisition among female sex workers in Uganda: evidence from a nested case–control study AID - 10.1136/sextrans-2013-051467 DP - 2014 Nov 01 TA - Sexually Transmitted Infections PG - 545--549 VI - 90 IP - 7 4099 - http://sti.bmj.com/content/90/7/545.short 4100 - http://sti.bmj.com/content/90/7/545.full SO - Sex Transm Infect2014 Nov 01; 90 AB - Objectives Cross-sectional studies have shown a strong association between Mycoplasma genitalium and HIV infections. We previously reported that in a cohort of female sex workers in Uganda, M genitalium infection at baseline was associated with HIV seroconversion. Here we examine the temporal association between the M genitalium infection status shortly before HIV seroconversion and HIV acquisition. Methods A nested case-control study was conducted within a cohort of women at high risk for HIV in Kampala. Cases were those of women acquiring HIV within 2 years of enrolment. For each of the 42 cases, 3 controls were selected from women HIV negative at the visit when the corresponding case first tested HIV seropositive. The association between HIV acquisition and M genitalium infection immediately prior to HIV testing was analysed using conditional logistic regression. Results There was weak evidence of an association between M genitalium infection and HIV acquisition overall (crude OR=1.57; 95% CI 0.67 to 3.72, aOR=2.28: 95% CI 0.81 to 6.47). However, time of M genitalium testing affected the association (p value for effect-modification=0.004). For 29 case-control sets with endocervical samples tested 3 months prior to the first HIV-positive result, M genitalium infection increased the risk of HIV acquisition (crude OR=3.09; 95% CI 1.06 to 9.05, aOR=7.19; 95% CI 1.68 to 30.77), whereas there was little evidence of an association among the 13 case-control sets with samples tested at an earlier visit (crude OR=0.30: 95% CI 0.04 to 2.51; aOR=0.34; 95% CI 0.02 to 5.94). Conclusions Our study showed evidence of a temporal relationship between M genitalium infection and HIV acquisition that suggests that M genitalium infection may be a co-factor in the acquisition of HIV infection.