Centre of Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany.
Infect Dis Poverty. 2023 Jul 6;12(1):64. doi: 10.1186/s40249-023-01114-y.
There is no recent epidemiological data on HIV infection in Gabon, particularly in pregnant women. To close this gap, an HIV-prevalence survey was conducted among Gabonese pregnant women, followed by a cross-sectional case-control study in which the prevalence of various co-infections was compared between HIV-positive and HIV-negative pregnant women.
Between 2018 and 2019, data for the HIV-prevalence survey were collected retrospectively in 21 Gabonese antenatal care centres (ANCs). Subsequently, for the prospective co-infection study, all HIV-positive pregnant women were recruited who frequented the ANC in Lambaréné and a comparator sub-sample of HIV-negative pregnant women was recruited; these activities were performed from February 2019 to February 2020. The mean number of co-infections was ascertained and compared between HIV-positive and HIV-negative women. Additionally, the odds for being co-infected with at least one co-infection was evaluated and compared between HIV-positive and HIV-negative women.
HIV-positivity was 3.9% (646/16,417) among pregnant women. 183 pregnant women were recruited in the co-infection study. 63% of HIV-positive and 75% of HIV-negative pregnant women had at least one co-infection. There was a trend indicating that HIV-negative women were more often co-infected with sexually transmitted infections (STIs) than HIV-positive women [mean (standard deviation, SD): 2.59 (1.04) vs 2.16 (1.35), respectively; P = 0.056]; this was not the case for vector-borne infections [mean (SD): 0.47 (0.72) vs 0.43 (0.63), respectively; P = 0.59].
Counterintuitively, the crude odds for concomitant STIs was lower in HIV-positive than in HIV-negative women. The change of magnitude from the crude to adjusted OR is indicative for a differential sexual risk factor profile among HIV-positive and HIV-negative women in this population. This might potentially be explained by the availability of sexual health care counselling for HIV-positive women within the framework of the national HIV control programme, while no such similar overall service exists for HIV-negative women. This highlights the importance of easy access to sexual healthcare education programmes for all pregnant women irrespective of HIV status.
加蓬最近没有关于 HIV 感染的流行病学数据，尤其是在孕妇中。为了弥补这一空白，对加蓬孕妇进行了 HIV 流行率调查，随后进行了一项横断面病例对照研究，比较了 HIV 阳性和 HIV 阴性孕妇之间各种合并感染的流行率。
2018 年至 2019 年，在 21 个加蓬产前保健中心（ANC）中回顾性收集 HIV 流行率调查数据。随后，在前瞻性合并感染研究中，招募了所有经常光顾兰巴雷内 ANC 的 HIV 阳性孕妇，并招募了 HIV 阴性孕妇的对照亚样本；这些活动于 2019 年 2 月至 2020 年 2 月进行。确定并比较了 HIV 阳性和 HIV 阴性妇女的合并感染平均数。此外，评估并比较了 HIV 阳性和 HIV 阴性妇女至少有一种合并感染的可能性。
孕妇中 HIV 阳性率为 3.9%（646/16417）。在合并感染研究中招募了 183 名孕妇。63%的 HIV 阳性和 75%的 HIV 阴性孕妇至少有一种合并感染。有一个趋势表明，HIV 阴性孕妇比 HIV 阳性孕妇更容易感染性传播感染（STI）[平均值（标准差，SD）：2.59（1.04）比 2.16（1.35），分别；P=0.056]；而对于虫媒传染病则并非如此[平均值（SD）：0.47（0.72）比 0.43（0.63），分别；P=0.59]。
出乎意料的是，HIV 阳性妇女同时感染 STI 的粗比值比 HIV 阴性妇女低。从粗比值到调整后的 OR 的变化幅度表明，在该人群中，HIV 阳性和 HIV 阴性妇女的性风险因素特征存在差异。这可能是由于在国家 HIV 控制计划框架内为 HIV 阳性妇女提供了性健康护理咨询服务，而 HIV 阴性妇女则没有类似的全面服务。这强调了为所有孕妇提供便捷获得性健康护理教育计划的重要性，无论其 HIV 状态如何。
