Quantifying geographical diversity in sexually transmitted infections using population attributable risk: results from HIV prevention trials in South Africa

Abstract

In this study, we investigated spatial diversities of sexually transmitted infections (STIs) and quantified their impacts on the STIs using population attributable risk (PAR%). The study population was 7,557 women who participated in several HIV prevention trials from KwaZulu-Natal, South Africa. Our results provide compelling evidence for substantial geographical diversities on STI incidence rates in the region. Their population-level impacts on the STIs exceeded the combined impacts of the individual risk factors considered in this study (PAR%: 41% (<25 years), 52% (25-34 years) and 34% (35+ years). When all these factors are considered together, PAR% was the highest among younger women (PAR%: 67%, 82% and 50% for <25, 25-34 and 35+ years old respectively). Results from our study will bring greater insight into the previous research by increasing our understanding of the impacts of the sub-geographical level variations of STI prevalence and incidence rates in the region.

Impact of recurrent sexually transmitted infections on HIV seroconversion: Results from multi-state frailty models

“…Main studies including descriptions of the study populations are published elsewhere. 18–23 Briefly, the inclusion criteria were similar across all the trials. They also used the similar HIV/STI testing methods.…”

“…Consistent with this priority, the current study aimed to quantify the association between HIV and STIs among women who participated in biomedical intervention trials and resided in KwaZulu-Natal, South Africa (2002–2016). 18–23 We primarily focused on quantifying the impact of recurrent STIs on HIV acquisition using transition-specific models. In our modelling approach, recurrent STIs are assumed to be the clinical intermediate event(s) before the HIV infection (or censoring/end of study) which was considered as a ‘ terminating event’ .…”