Self-collected specimens for hrHPV mRNA testing seemed to have similar sensitivity and specificity as physician-collected specimens for the detection of ≥HSIL among high-risk women.

A moderated mobile-based support group service for pregnant women and new mothers is safe and feasible. Additional research using experimental designs to strengthen evidence of the effectiveness of the support intervention is warranted.

eThe prevalence of Mycoplasma genitalium is high in vulnerable populations of women in low-resource settings. However, the epidemiology of infection in these populations is not well established. To determine the prevalence of Mycoplasma genitalium and its association with cervical cytology and other correlates, we recruited 350 female sex workers (FSW) who were 18 to 50 years old in Nairobi, Kenya, for a cross-sectional study. A questionnaire was administered at baseline to obtain information on sociodemographics and sexual behaviors. Women underwent a pelvic exam, during which a physician collected cervical-exfoliation samples for conventional cytology and sexually transmitted infection (STI) testing. Samples were tested for M. genitalium Mycoplasma genitalium is an emergent bacterium that is transmitted via sexual activity and has been associated with complications in the female genital tract, including endometritis, tubal-factor infertility, pelvic inflammatory disease (PID), cervicitis, and ectopic pregnancy (1-9). M. genitalium may also increase the risk of HIV transmission and associated shedding (10-13).Vulnerable populations of women in low-resource settings have a higher-than-average susceptibility to sexually transmitted infections (STIs) and subsequent complications of the reproductive tract, including those caused by M. genitalium, Chlamydia trachomatis, and Neisseria gonorrhoeae (14). In the case of female sex workers (FSWs), STI risk is increased due to a greater exposure to unsafe sexual behaviors, such as unprotected sexual intercourse and high numbers of clients/sexual partners (15).The prevalence and associated risk factors for M. genitalium have been investigated both in the general population and among populations at high risk for STIs in sub-Saharan Africa, Asia, the United Kingdom, and the United States (4, 16-23). Across many of these studies, a young age, little education, single marital status, and high numbers of sex partners remained consistently associated with infection (4,9,16,18,21,23,24). Findings are less consistent among the few studies that examined risk factors among FSWs. In the literature, studies have shown similar associations of M. genitalium infection with basic demographic factors, such as education and marital status. However, there is less agreement for sexual-behavioral and clinical correlates, such as condom use, duration of sex work, and history of STIs (16,18,23). Chinese sex workers who did not present STI symptoms in the year prior to the study were more likely to have infection with M. genitalium than those who did (23). In contrast, a study conducted in sub-Saharan Africa found that sex workers who presented clinical symptoms were more likely to have M. genitalium infection than those who were asymptomatic (18).In studies examining concurrent M. genitalium infection with other STIs in the general population, M. genitalium was found to be associated with urethritis, cervicitis, and PID (25-28). However, more-recent research indicates the role of M. genitalium ...

We estimated type-specific prevalence of human papillomavirus (HPV) and examined risk factors for abnormal cervical cytology among 296 female sex workers from Nairobi, Kenya. Over half (54%) were infected with a high-risk (HR) HPV type, of which HPV16 and 52 were the most common types. HIV-1 prevalence was 23% and HIV-1 sero-positivity was associated with high-grade cervical lesions, particularly among women with CD4 count less than 500 cells/mm(3) (odds ratio [OR] = 6.9; 95% confidence interval [CI]: 1.7-24.9). Among women who had normal cytology at the time of entry into the study, the risk of having an abnormal Pap smear within one year was significantly elevated for women with multiple HPV types at study entry (adjusted odds ratio [aOR] = 6.0; 95% CI: 2.3-15.7) and with a subset of HR HPV types (aOR = 4.2; 95% CI: 1.6-11.2). Detection of multiple concurrent HPV infections may be a useful marker to identify women at risk of developing precancerous lesions in populations of high HPV prevalence.

Background Trichomonas vaginalis (TV) is the most common curable sexually transmitted infection (STI) worldwide. Trichomonas vaginalis infection is associated with an increased risk of pelvic inflammatory disease, human immunodeficiency virus transmission, and preterm birth in women. Data on the prevalence and risk factors for TV infection in sub-Saharan African countries remain scarce. Methods A total of 350 Kenyan female sex workers, aged 18 to 50 years, participated in a 2-year longitudinal study of the acquisition of STIs, including TV infection. Every 3 months, cervical and vaginal brush samples were collected for STI testing. At baseline, a sociodemographic and behavior questionnaire was administered. Testing for TV, Chlamydia trachomatis (CT), Neisseria gonorrhoeae, Mycoplasma genitalium, and high-risk human papillomavirus was performed using APTIMA assays. Results The TV baseline prevalence was 9.2% (95% confidence interval [95% CI], 6.3–12.7%) and 2-year cumulative TV incidence was 8.1 per 1000 person months (6.9–9.3). Risk factors for higher TV prevalence at baseline were CT infection (adjusted prevalence ratio [PR], 8.53; 95% CI, 3.35–21.71), human immunodeficiency virus seropositivity (PR, 3.01; 95% CI, 1.45, 6.24) and greater than 4 years of sex work (PR, 2.66; 95% CI, 1.07–6.60). Risk factors for elevated 2-year TV incidence were CT (hazard ratio [HR], 4.28; 95% CI, 1.36–13.50), high-risk human papillomavirus infection (HR, 1.91; 95% CI, 1.06–3.45) and history of smoking (HR, 2.66; 95% CI, 1.24–5.73). Discussion CT infection was positively associated with both prevalent and 2-year incident TV infections.