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Prevalence of sexually transmitted infections in HIV-1 infected pregnant women in Europe
Authors:Megan Landes  Claire Thorne  Patricia Barlow  Simona Fiore  Ruslan Malyuta  Pasquale Martinelli  Svetlana Posokhova  Valeria Savasi  Igor Semenenko  Andrej Stelmah  Cecilia Tibaldi  Marie-Louise Newell
Affiliation:(1) Department of Family and Community Medicine, University of Toronto, Toronto, Canada;(2) Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK;(3) Department of Obstetrics and Gynecology, Hospital St Pierre, Brussels, Belgium;(4) Department of Obstetrics and Gynecology, Hospital L.Sacco, University of Milan, Milan, Italy;(5) Prevention of Perinatal AIDS Initiative, Odessa, Ukraine;(6) Department of Gynecology and Obstetrics, University of Naples, Federico II, Naples, Italy;(7) Department of Obstetrics and Gynecology, Odessa Regional Hospital, Odessa, Ukraine;(8) AIDS Centre of Crimea, Simferopol, Ukraine;(9) Department of Obstetrics and Gynecology, Hospital S Anna, Turin, Italy
Abstract:
We investigated prevalence of sexually transmitted infections (STI) in a cohort of HIV-1-infected pregnant women and described factors associated with STI diagnosis, as a nested study within the European Collaborative Study (ECS). The ECS is a cohort study in which HIV-infected pregnant women are enrolled and their children followed from birth, according to standard clinical and laboratory protocols. Information on STIs diagnosed during pregnancy was collected retrospectively from the antenatal records of women enrolling between January 1999 and October 2005; other variables were obtained from the ECS prospective database. A total of 1,050 women were included: 530 in Western Europe and 520 in Ukraine. Syphilis was the most common bacterial STI (2% prevalence, 95% CI 1.2–3.0). Prevalence of HPV-related genital lesions was 8.6% (95%CI 6.9–10.4) and prevalence of Trichomonas vaginalis was 12.1% (95%CI 10.2–14.2). Women in Ukraine (AOR 10.7, 95%CI 3.7–30.5), single women (AOR 3.9, 95%CI 1.2–12.7), sexual partners of injecting drug users (AOR 3.8, 95%CI 1.4–10.4) and women with CD4 counts <200 cells/mm3 (AOR 5.4, 95%CI 1.0–28.1) were at increased risk of diagnosis with Chlamydia trachomatis, syphilis or Trichomonas vaginalis. African origin (AOR 1.9, 95%CI 1.1–3.3) and CD4 count <200 cells/mm3 (AOR 3.4, 95%CI 1.5–7.8) were associated with HSV-2 and/or HPV-related genital lesions. Antenatal screening should be considered an effective tool for diagnosis, treatment and prevention of further transmission of STIs. HIV-infected women should receive adequate screening for STIs during pregnancy together with appropriate counseling and follow-up for treatment and prevention. Electronic Supplementary Material The online version of this article (doi:) contains supplementary material, which is available to authorized users.
Keywords:Antenatal  Human immunodeficiency virus  Prevalence  Risk factors  Sexually transmitted infection
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