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选择宫内节育避孕的HIV阳性女性中性传播感染的患病率及相关因素

Prevalence and factors associated with sexually transmitted infections among HIV positive women opting for intrauterine contraception.

作者信息

Kakaire Othman, Byamugisha Josaphat Kayogoza, Tumwesigye Nazarius Mbona, Gamzell-Danielsson Kristina

机构信息

Department of Obstetrics and Gynecology, Makerere University College of Health Sciences, Mulago Hospital Complex, Old Mulago Hill, Kampala, Uganda.

School of Public Health, Makerere University College of Health Sciences, Mulago Hospital Complex, Old Mulago Hill, Kampala Uganda.

出版信息

PLoS One. 2015 Apr 10;10(4):e0122400. doi: 10.1371/journal.pone.0122400. eCollection 2015.

Abstract

BACKGROUND

Women living with HIV/AIDS (WLHA) are a high risk group for sexually transmitted infections (STIs). However, the majority of women with STIs are asymptomatic. Data on prevalence of STIs among WLHA in Uganda are limited. The objective of the study was to determine prevalence and factors associated with STIs among WLHA opting for intrauterine contraceptive device (IUD).

METHODS

Three hundred fifty one WLHA deemed free of STIs using a syndromic logarithm were enrolled into the study. Endo-cervical swabs were taken before IUD insertion and PCR test for Nisseria gonorrhea (NG), Trichomonas vaginalis (TV) and Chlamydia trachomatis (CT) infections conducted.

RESULTS

Participants' mean age was 29.4 ± 6.2 years, 83% were under 35years, 50% had secondary education and 73% were married. The majority (69%) had disclosed their HIV sero status to their spouses, 82% used Cotrimoxazole prophylaxis, 70% were on antiretroviral therapy, 90% had CD4 count greater than 350, about 60% reported condoms use and 70% were of parity 2-4. Over 50% of the participants' spouses were older than 35 years and 72% had attained secondary education. STIs prevalence was 11.1%, (95% CI 7.8-14.4) and individual prevalence for TV, NG, and CT was 5.9%, 5.4% and 0.9% respectively. Factors independently associated with STI were having primary or less education (OR= 2.3, 95% CI: 1.09 - 4.85) having a spouse of primary or less education (OR= 3.3, 95% CI: 1.6 - 6.78) and muslim faith (OR= 0.2, 95% CI: 0.04 - 0.78).

CONCLUSION

STI prevalence was 11.1%. TV and NG were the commonest STIs in this population. Having primary or less education for both participant and spouse was associated with increased risk while being of muslim faith was associated with reduced risk of STI.

摘要

背景

感染艾滋病毒/艾滋病的女性(WLHA)是性传播感染(STIs)的高危人群。然而,大多数性传播感染女性并无症状。乌干达感染艾滋病毒/艾滋病女性中性传播感染患病率的数据有限。本研究的目的是确定选择宫内节育器(IUD)的感染艾滋病毒/艾滋病女性中性传播感染的患病率及其相关因素。

方法

使用症状对数法筛选出351名被认为无性病的感染艾滋病毒/艾滋病女性纳入研究。在插入宫内节育器前采集宫颈拭子,并对淋病奈瑟菌(NG)、阴道毛滴虫(TV)和沙眼衣原体(CT)感染进行聚合酶链反应检测。

结果

参与者的平均年龄为29.4±6.2岁,83%年龄在35岁以下,50%接受过中等教育,73%已婚。大多数(69%)已向配偶披露其艾滋病毒血清学状态,82%使用复方新诺明预防,70%接受抗逆转录病毒治疗,90%的CD4细胞计数大于350,约60%报告使用避孕套,70%生育2 - 4胎。超过50%参与者的配偶年龄大于35岁,72%接受过中等教育。性传播感染患病率为11.1%(95%可信区间7.8 - 14.4),阴道毛滴虫、淋病奈瑟菌和沙眼衣原体的个体患病率分别为5.9%、5.4%和0.9%。与性传播感染独立相关的因素包括接受小学及以下教育(比值比=2.3,95%可信区间:1.09 - 4.85)、配偶接受小学及以下教育(比值比=3.3,95%可信区间:1.6 - 6.78)以及穆斯林信仰(比值比=0.2,95%可信区间:0.04 - 0.78)。

结论

性传播感染患病率为11.1%。阴道毛滴虫和淋病奈瑟菌是该人群中最常见的性传播感染。参与者及其配偶接受小学及以下教育会增加感染风险,而穆斯林信仰与性传播感染风险降低有关。

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