Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; School of Laboratory Medicine & Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa.
Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.
Int J Infect Dis. 2020 Sep;98:130-137. doi: 10.1016/j.ijid.2020.06.046. Epub 2020 Jun 17.
Sexually transmitted infections (STIs) and Human immunodeficiency virus (HIV) share a complex bidirectional relationship, however, population prevalence and the association between the presence of STIs and HIV in a high HIV burden district in KwaZulu-Natal, South Africa is not known.
A total of 9812 participants aged 15-49 years were enrolled in a cross-sectional population-based household survey. Participants completed a structured questionnaire and provided first-pass urine (males) or self-collected vulvo-vaginal swabs (females) for the detection of STIs.
Prevalence of herpes simplex virus type-2 (HSV-2) was 57.8%, syphilis was 1.6%, Neisseria gonorrhoeae was 2.8%, Chlamydia trachomatis was 7.1%, Trichomonas vaginalis was 9.0%, Mycoplasma genitalium was 5.5% and HIV was 36.3%. HIV positive status was associated with an increased probability of having M. genitalium (aPR = 1.49, 95% CI 1.02-2.19) among males and syphilis (aPR = 2.54, 95% CI 1.32-4.86), N. gonorrhoeae (aPR = 2.39, 95% CI 1.62-3.52), T. vaginalis (aPR = 1.70, 95% CI 1.43-2.01) and M. genitalium (aPR = 1.60, 95% CI 1.15-2.22) among females. HIV viral load ≥400 copies per mL was associated with an increased probability of N. gonorrhoeae (aPR = 1.91, 95% CI 1.36-2.70), C. trachomatis (aPR = 1.52, 95% CI 1.12-2.05) and M. genitalium (aPR = 1.83, 95% CI 1.27-2.63).
The high prevalence of STIs and the association between STIs and HIV, and HIV viral load underscores the public health implications of sustained transmission risk of STIs and HIV. These findings highlight the urgent need for expanding STI surveillance and implementing interventions to monitor and reduce the STI burden.
性传播感染（STIs）和人类免疫缺陷病毒（HIV）之间存在复杂的双向关系，然而，在南非夸祖鲁-纳塔尔省一个 HIV 负担沉重的地区，人群流行率以及 STIs 和 HIV 之间的关联尚不清楚。
共有 9812 名年龄在 15-49 岁的参与者参加了一项基于人群的横断面家庭调查。参与者完成了一份结构化问卷，并提供了第一份尿液（男性）或自我采集的阴道-外阴拭子（女性），以检测 STIs。
单纯疱疹病毒 2 型（HSV-2）的流行率为 57.8%，梅毒为 1.6%，淋病奈瑟菌为 2.8%，沙眼衣原体为 7.1%，阴道毛滴虫为 9.0%，解脲支原体为 5.5%，HIV 为 36.3%。HIV 阳性状态与男性中解脲支原体（aPR = 1.49，95%CI 1.02-2.19）和梅毒（aPR = 2.54，95%CI 1.32-4.86）、淋病奈瑟菌（aPR = 2.39，95%CI 1.62-3.52）、阴道毛滴虫（aPR = 1.70，95%CI 1.43-2.01）和解脲支原体（aPR = 1.60，95%CI 1.15-2.22）的可能性增加相关，女性中 HIV 病毒载量≥400 拷贝/毫升与淋病奈瑟菌（aPR = 1.91，95%CI 1.36-2.70）、沙眼衣原体（aPR = 1.52，95%CI 1.12-2.05）和解脲支原体（aPR = 1.83，95%CI 1.27-2.63）的可能性增加相关。
STIs 的高流行率以及 STIs 和 HIV 之间的关联，以及 HIV 病毒载量，突出了持续存在的 STIs 和 HIV 传播风险对公共卫生的影响。这些发现强调了迫切需要扩大 STI 监测并实施干预措施，以监测和减少 STI 负担。
