Risk factors for incidence of sexually transmitted infections among women in south africa, tanzania, and zambia: Results from HPTN 055 study

Saidi Kapiga, Cliff Kelly, Stephen M Weiss, Tara Daley, Leigh Peterson, Corey Leburg, Gita Ramjee

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

OBJECTIVE: To determine risk factors for sexually transmitted infections (STIs) among women in Durban and Hlabisa (South Africa), Moshi (Tanzania), and Lusaka (Zambia). STUDY DESIGN: Between 2003 and 2004, 958 women at risk of STIs were enrolled in a 1-year prospective study. They were interviewed at each monthly visit, and samples for STI testing were collected during quarterly and other visits when clinically indicated. RESULTS: The incidence of infections as measured in person-years at risk (PYAR) was as follows: overall trichomoniasis, 31.9/100 PYAR; chlamydial infection in South Africa, 19.5/100 PYAR; chlamydial infection in Tanzania and Zambia, 4.9/100 PYAR; gonorrhea in South Africa, 16.5/100 PYAR; gonorrhea in Tanzania and Zambia, 5.3/100 PYAR; overall syphilis, 7.5/100 PYAR; and overall HIV, 3.8/100 PYAR. The incidence of most STIs was highest among the South African sites, where chlamydial infection and gonorrhea were detected by using a more sensitive assay. Independent risk factors included age, hormonal contraceptive methods, and measures of sexual behavior, including number of sex partners and occurrence of anal sex in the past 3 months. Women with incident HIV infection were at increased risk of chlamydial infection [odds ratio (OR) = 5.5, 95% confidence interval (CI): 2.0-15.2]and gonorrhea (OR = 5.7, 95% CI: 1.9-17.0) in South African sites. Despite ongoing counseling during the study, high-risk sexual behaviors were common, and consistent condom use remained low. CONCLUSIONS: The incidence of STIs, including HIV, was high among women in this study. These findings highlight the urgent need for effective HIV/STI prevention programs in this population.

Original languageEnglish
Pages (from-to)199-206
Number of pages8
JournalSexually Transmitted Diseases
Volume36
Issue number4
DOIs
StatePublished - Apr 1 2009

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Zambia
Tanzania
Sexually Transmitted Diseases
South Africa
Incidence
Gonorrhea
Sexual Behavior
Infection
HIV
Odds Ratio
Confidence Intervals
Population Control
Condoms
Syphilis
Risk-Taking
Contraception
HIV Infections
Counseling
Prospective Studies

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Risk factors for incidence of sexually transmitted infections among women in south africa, tanzania, and zambia : Results from HPTN 055 study. / Kapiga, Saidi; Kelly, Cliff; Weiss, Stephen M; Daley, Tara; Peterson, Leigh; Leburg, Corey; Ramjee, Gita.

In: Sexually Transmitted Diseases, Vol. 36, No. 4, 01.04.2009, p. 199-206.

Research output: Contribution to journalArticle

Kapiga, Saidi ; Kelly, Cliff ; Weiss, Stephen M ; Daley, Tara ; Peterson, Leigh ; Leburg, Corey ; Ramjee, Gita. / Risk factors for incidence of sexually transmitted infections among women in south africa, tanzania, and zambia : Results from HPTN 055 study. In: Sexually Transmitted Diseases. 2009 ; Vol. 36, No. 4. pp. 199-206.
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AU - Weiss, Stephen M

AU - Daley, Tara

AU - Peterson, Leigh

AU - Leburg, Corey

AU - Ramjee, Gita

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AB - OBJECTIVE: To determine risk factors for sexually transmitted infections (STIs) among women in Durban and Hlabisa (South Africa), Moshi (Tanzania), and Lusaka (Zambia). STUDY DESIGN: Between 2003 and 2004, 958 women at risk of STIs were enrolled in a 1-year prospective study. They were interviewed at each monthly visit, and samples for STI testing were collected during quarterly and other visits when clinically indicated. RESULTS: The incidence of infections as measured in person-years at risk (PYAR) was as follows: overall trichomoniasis, 31.9/100 PYAR; chlamydial infection in South Africa, 19.5/100 PYAR; chlamydial infection in Tanzania and Zambia, 4.9/100 PYAR; gonorrhea in South Africa, 16.5/100 PYAR; gonorrhea in Tanzania and Zambia, 5.3/100 PYAR; overall syphilis, 7.5/100 PYAR; and overall HIV, 3.8/100 PYAR. The incidence of most STIs was highest among the South African sites, where chlamydial infection and gonorrhea were detected by using a more sensitive assay. Independent risk factors included age, hormonal contraceptive methods, and measures of sexual behavior, including number of sex partners and occurrence of anal sex in the past 3 months. Women with incident HIV infection were at increased risk of chlamydial infection [odds ratio (OR) = 5.5, 95% confidence interval (CI): 2.0-15.2]and gonorrhea (OR = 5.7, 95% CI: 1.9-17.0) in South African sites. Despite ongoing counseling during the study, high-risk sexual behaviors were common, and consistent condom use remained low. CONCLUSIONS: The incidence of STIs, including HIV, was high among women in this study. These findings highlight the urgent need for effective HIV/STI prevention programs in this population.

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