RT Journal Article SR Electronic T1 High prevalence and incidence of gonorrhoea and chlamydia in young women eligible for HIV pre-exposure prophylaxis in South Africa and Zimbabwe: results from the HPTN 082 trial JF Sexually Transmitted Infections JO Sex Transm Infect FD BMJ Publishing Group Ltd SP sextrans-2022-055696 DO 10.1136/sextrans-2022-055696 A1 Sinead Delany-Moretlwe A1 Nyaradzo Mgodi A1 Linda-Gail Bekker A1 Jared M Baeten A1 Chuwen Li A1 Deborah Donnell A1 Yaw Agyei A1 Denni Lennon A1 Scott M Rose A1 Marcia Mokgatle A1 Sheetal Kassim A1 Shorai Mukaka A1 Adeola Adeyeye A1 Connie Celum YR 2023 UL http://sti.bmj.com/content/early/2023/03/07/sextrans-2022-055696.abstract AB Introduction We investigated the prevalence, incidence and factors associated with sexually transmitted infections (STIs) among young African women seeking HIV pre-exposure prophylaxis (PrEP).Methods HPTN 082 was a prospective, open-label PrEP study enrolling HIV-negative sexually active women aged 16–25 years in Cape Town and Johannesburg, South Africa, and Harare, Zimbabwe. Endocervical swabs from enrolment, months 6 and 12 were tested for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) by nucleic acid amplification, and Trichomonas vaginalis (TV) by a rapid test. Intracellular tenofovir-diphosphate (TFV-DP) concentrations in dried blood spots were measured at months 6 and 12. Associations between risk characteristics and STI outcomes were assessed using Poisson regression.Results Of 451 enrolled participants, 55% had an STI detected at least once. CT incidence was 27.8 per 100 person-years (py) (95% CI 23.1, 33.2), GC incidence was 11.4 per 100 py (95% CI 8.5, 15.0) and TV incidence was 6.7 per 100 py (95% CI 4.5, 9.5). 66% of incident infections were diagnosed in women uninfected at baseline. Baseline cervical infection (GC or CT) risk was highest in Cape Town (relative risk (RR) 2.38, 95% CI 1.35, 4.19) and in those not living with family (RR 1.87, 95% 1.13, 3.08); condom use was protective (RR 0.67, 95% CI 0.45, 0.99). Incident CT was associated with baseline CT (RR 2.01; 95% CI 1.28, 3.15) and increasing depression score (RR 1.05; 95% CI 1.01, 1.09). Incident GC was higher in Cape Town (RR 2.40; 95% CI 1.18, 4.90) and in participants with high PrEP adherence (TFV-DP concentrations ≥700 fmol/punch) (RR 2.04 95% CI 1.02, 4.08).Conclusion Adolescent girls and young women seeking PrEP have a high prevalence and incidence of curable STIs. Alternatives to syndromic management for diagnosis and treatment are needed to reduce the burden of STIs in this population.Trial registration number NCT02732730.Data are available upon reasonable request.