Sexually transmitted infections among HIV-infected and HIV-uninfected women in the Tapajós region, Amazon, Brazil: Self-collected vs. clinician-collected samples

Abstract

The anogenital prevalence of sexually transmitted infections (STIs) and the use of cervico-vaginal self-collected vs. clinician-collected samples were evaluated for the diagnosis of human immunodeficiency virus (HIV)-infected and HIV-uninfected women in the Tapajós region, Amazon, Brazil. We recruited 153 women for a cross-sectional study (112 HIV-uninfected and 41 HIV-infected) who sought health services. Anal and cervical scrapings and cervico-vaginal self-collection samples were collected. Real-time polymerase chain reaction methods were used for Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis and Mycoplasma genitalium . A syphilis test was also performed. Risk factors for STIs were identified by multivariate analysis. The overall prevalence of STIs was 30.4% (34/112) in HIV-uninfected women and 24.4% (10/41) in HIV-infected women. Anogenital Chlamydia trachomatis infection was the most prevalent in both groups of women (20.5% vs 19.5%). There was significant agreement for each STI between self-collected and clinician-collected samples: 91.7%, kappa 0.67, 95% confidence interval (CI) 0.49–0.85 for Chlamydia trachomatis ; 99.2%, kappa 0.85, 95% CI 0.57–1.00 for Neisseria gonorrhoeae ; 97.7%, kappa 0.39, 95% CI -0.16–0.94 for Trichomonas vaginalis ; and 94.7%, kappa 0.51, 95% CI 0.20–0.82 for Mycoplasma genitalium . Women with human papillomavirus had coinfection or multiple infections with other STIs. Risk factors for STIs were being ≤ 25 years old, being employed or a student, reporting a history of STI and having a positive HPV test. A high prevalence of STIs in women in the Tapajós region was found. Cervico-vaginal self-collection is a useful tool for STI screening and can be used in prevention control programs in low-resource settings, such as in northern Brazil.

Prevalence of coinfections in women living with human immunodeficiency virus in Northeast Brazil

“…In this study, most coinfections were prevalent between 1.8 and 3.9, except for syphilis, which had a rate of 9.1. A high prevalence of syphilis in women living with HIV was also reported by a study conducted in the Amazon region of Brazil 6 .…”

Sex differences in the prevalence and determinants of HPV-related external genital lesions in young adults: a national cross-sectional survey in Brazil

“…The higher prevalence of genital lesions in men could be explained by the higher frequency of STIs in this population [ 17 ]. A previous study performed in the women from a region on the North of Brazil associated HPV with other STIs, suggesting that individuals with HPV infection are at an increased risk of having another STI [ 27 ]. Similar results have already been reported in Seoul, Korea and Trieste, Italy [ 28 , 29 ].…”

Prevalence and Factors Associated With Syphilis in People Living With HIV/AIDS in the State of Pará, Northern Brazil

“…The sample size determination was based on the estimated prevalence of syphilis in the general population and on the estimative of individuals enrolled in Specialized Reference Unit on Special Infectious and Parasitic Diseases in 2018 (approximately 7,420 patients, of which 5,219 were PLWHA). An estimated prevalence of 10% of active syphilis in PLWHA (12)(13)(14) resulted in a minimum sample size of 491 individuals. The sample error (ε) assumed in the present calculation was 5%, and a test power of 80% was established.…”