The relative contribution of viral and bacterial sexually transmitted infections on HIV acquisition in southern African women in the Methods for Improving Reproductive Health in Africa study.
Int J STD AIDS
; 22(4): 218-24, 2011 Apr.
Article
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| MEDLINE
| ID: mdl-21515755
ABSTRACT
We assess the relative contribution of viral and bacterial sexually transmitted infections (STIs) on HIV acquisition among southern African women in a nested case-control study within the Methods for Improving Reproductive Health in Africa (MIRA) trial. Cases were women with incident HIV infection; controls were HIV-uninfected at the time of case seroconversion selected in a 1 to 3 case to control ratio (risk-set sampling), matched on study site and time of follow-up. Conditional logistic regression models were used to calculate adjusted odds ratios (AORs) and population-attributable fractions (PAF). Among 4948 enrolled women, we analysed 309 cases and 927 controls. The overall HIV incidence rate was 4.0 per 100 women-years. The incidence of HIV infection was markedly higher in women who had prevalent Herpes simplex virus type 2 (HSV-2) (AOR 2.14; 95% confidence interval [CI] 1.55-2.96), incident HSV-2 (AOR 4.43; 95% CI 1.77-11.05) and incident Neisseria gonorrhoeae (AOR 6.92; 95% CI 3.01-15.90). The adjusted PAF of HIV incidence for prevalent HSV-2 was 29.0% (95% CI 16.8-39.3), for incident HSV-2 2.1% (95% CI 0.6-3.6) and for incident N. gonorrhoeae 4.1% (95% CI 2.5-5.8). Women's greatest risk factors for HIV acquisition were incident bacterial and viral STIs. Women-centred interventions aimed at decreasing HIV incidence in young African women need to address these common co-morbid conditions.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Gonorrea
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Herpes Genital
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Enfermedades de Transmisión Sexual
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Infecciones por VIH
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
País/Región como asunto:
Africa
Idioma:
En
Revista:
Int J STD AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2011
Tipo del documento:
Article
País de afiliación:
Estados Unidos