Prevalence and predictors of cervicitis in female sex workers in Peru: an observational study

Abstract

BackgroundCervicitis is a syndrome of cervical inflammation and a common condition in female sex workers (FSW), a subpopulation vulnerable to sexually transmitted infections. Local data is essential for guiding syndromic management of cervicitis in FSW working in Peru. We sought to describe the prevalence and etiologies of cervicitis in this population. We also aimed to identify sociodemographic, behavioral and biological factors associated with cervicitis, including bacterial vaginosis (BV), a condition with a possible role in cervicitis.MethodsFSW 18 years of age or older presenting to a free public sexual health clinic in Callao-Lima, Peru were eligible for inclusion upon consent. 467 participants completed a face-to-face questionnaire and underwent genital examination. Vaginal, endocervical and blood samples were collected and tested for C. trachomatis (CT), N. gonorrhea (GC), T. vaginalis (TV), BV, HIV and Human T-Cell Lymphotropic Virus −1. Logistic regression was used to determine whether sociodemographic, behavioral, or other sexual health related characteristics were associated with the diagnosis of cervicitis.ResultsCervicitis was detected in 99 (24.9%) of 397 FSW. The presence of cervicitis was unable to be determined in 70 participants. In women with cervicitis, CT was present in 4.6% (4/87), TV in 4.0% (4/99), GC in 0% (0/87) and no pathogen was detected on cervical microbiology in 91.9% (91/99). BV was detected on vaginal microbiology in 36.9% (31/84) of cervicitis cases. BV was more common in women with cervicitis, however this association did not reach statistical significance (aOR = 1.47 [0.87, 2.48], p = 0.15). Other STI were not associated with cervicitis. Regular clinic attendance (aOR = 0.54 [0.34, 0.87], p = 0.01) and Ecuadorian nationality (aOR = 0.31 [0.13, 0.76], p = 0.01) were associated with reduced risk of cervicitis.ConclusionsCervicitis was common in FSW working Peru and was predominantly nongonococcal and non-chlamydial in etiology. Further study is warranted to clarify the role of BV and other emerging cervicitis pathogens in this population. The current Peruvian program of free health checks for FSW may be effective for reducing rates of cervicitis. The protective effect of Ecuadorian nationality prompts further study.

What are the most common sexually transmitted bacteria in women with cervico-vaginitis nowadays?

“…Our prevalence of cervico-vaginitis in women consulting for gynecological problems (12%) was lower than that of 24.9% observed in Peru among female sex workers. [ 4 ] Our incidence might even be higher than what was found, given that not all women go to hospitals when they are sick. [ 3 ] This low rate in our series might be explained also by the fact that our women came from the general population and not from female sex workers as was the case in the study in Peru.…”

“…[ 3 ] This low rate in our series might be explained also by the fact that our women came from the general population and not from female sex workers as was the case in the study in Peru. [ 4 ] Nevertheless, some women in our study have to depend on their partner(s), given the high rate of poverty in our country. That might be a reason for which the majority of them (69.6%) had ≥2 sexual partners.…”

Diagnostic test of urine sample, vaginal smear and combination of urine with vaginal smear to identify Neisseria gonorrhoeae with polymerase chain reaction method

“…as shown in Table 6. 10 Silfanus et al, found in their study that most of the FSWs in Medan were in the age group of 25-29 years old with 67 women (27.0%). 11 Topik found in his study that most of the FSWs in Bandar Baru, Deli Serdang, were in the age group of 20-24 years old with 28 women (53.8%).…”

“…The research conducted by Pollet regarding the prevalence of cervicitis among FSWs in Peru, stated that the average length of work as an FSW was between 24 to 36 months. 10 Topik in his study, which examined the proportion of FSWs coinfected with Neisseria gonorhoeae and Chlamydia trachomatis in Bandar Baru, Deli Serdang, had different results. He got the longest working time as an FSW was less than 12 months as many as 30 women (57.7%).…”

Nongonococcal cervicitis: The most common cause of fluor albus in female sex workers

“…The main complaint is vaginal discharge (fluor albus) or bleeding within menstrual period, although cervicitis may also be asymptomatic. 2 Laboratory infrastructures in majority region in Indonesia are still not optimal, so the data of STIs in various regions are largely based on syndrome approach. Thus far, there has been no research of STIs prevalence in female sex worker subpopulations represented in Surabaya.…”