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巴西感染人类免疫缺陷病毒的女性沙眼衣原体和淋病奈瑟菌的患病率及相关因素:一项多中心研究。

Prevalence of Chlamydia trachomatis and Neisseria gonorrhea and associated factors among women living with Human Immunodeficiency Virus in Brazil: a multicenter study.

作者信息

Miranda Angelica E, Silveira Mariangela F, Travassos Ana Gabriela, Tenório Teresinha, Val Isabel Cristina Chulvis do, Lannoy Leonor de, Junior Hortensio Simões de Mattos, Carvalho Newton Sergio de

机构信息

Universidade Federal do Espírito Santo, Vitória, ES, Brazil.

Universidade Federal de Pelotas, Pelotas, RS, Brazil.

出版信息

Braz J Infect Dis. 2017 Jul-Aug;21(4):402-407. doi: 10.1016/j.bjid.2017.03.014. Epub 2017 May 18.

Abstract

BACKGROUND

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) cause infections in the female genital tract, increasing susceptibility to and infectiousness of HIV. The objectives of the present study were to determine the prevalence and associated factors of CT and GC infection among HIV-infected women in Brazil.

METHODS

Cross-sectional study conducted from March to December 2015, including HIV-infected women attending referral centers in nine states of Brazil, aged 18-49 years, nonpregnant. An interview was conducted including socio-demographic, epidemiological and clinical characteristics. After the interview, gynecological examination was conducted to collect cervical cytology and vaginal secretion to C. trachomatis and N. gonorrhoeae tests through molecular biology.

RESULTS

A total of 802 (89.1%) women participated. The prevalence of CT was 2.1% (17/802) and CG was 0.9% (7/802). The prevalence of a positive test for both CT and/or GC was 2.7%. The factors associated with positive CT/GC test in the multivariate logistic regression analysis were abnormal Papanicolau smear (OR 4.1; 95% CI: 1.54-11.09) and the presence of abnormal cervical discharge (OR 2.6; 95% CI: 1.02-6.71). Among 377 women who reported previous STI 245 (65.0%) reported using condom more frequently after being diagnosed. 62 (16.4%) discovered the STI after the partner told he was infected; 157 (41.6%) had STI symptoms and looked for care, and 158 (41.9%) discovered it in a routine consultation for another reason.

CONCLUSIONS

The control of STI represents a unique opportunity to improve reproductive health of women living with HIV. STI diagnosis can change their behavior and reduce the sexual transmission of HIV and bacterial STI.

摘要

背景

沙眼衣原体(CT)和淋病奈瑟菌(GC)可引起女性生殖道感染,增加感染HIV的易感性和传染性。本研究的目的是确定巴西HIV感染女性中CT和GC感染的患病率及相关因素。

方法

2015年3月至12月进行的横断面研究,纳入年龄在18 - 49岁、非妊娠、在巴西九个州的转诊中心就诊的HIV感染女性。进行了一次访谈,包括社会人口学、流行病学和临床特征。访谈后,进行妇科检查以收集宫颈细胞学和阴道分泌物,通过分子生物学检测CT和GC。

结果

共有802名(89.1%)女性参与。CT的患病率为2.1%(17/802),CG的患病率为0.9%(7/802)。CT和/或GC检测呈阳性的患病率为2.7%。多因素逻辑回归分析中与CT/GC检测呈阳性相关的因素是巴氏涂片异常(比值比4.1;95%可信区间:1.54 - 11.09)和宫颈分泌物异常(比值比2.6;95%可信区间:1.02 - 6.71)。在377名报告既往有性传播感染的女性中,245名(65.0%)报告在被诊断后更频繁地使用避孕套。62名(16.4%)在伴侣告知其感染后发现性传播感染;157名(41.6%)有性传播感染症状并寻求治疗,158名(41.9%)因其他原因在常规会诊中发现。

结论

性传播感染的控制是改善HIV感染女性生殖健康的独特机会。性传播感染的诊断可以改变她们的行为,减少HIV和细菌性传播感染的性传播。

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