Open AccessSexually transmitted infections among HIV-infected and HIV-uninfected women in the Tapajós region, Amazon, Brazil: Self-collected vs. clinician-collected samples
Author(s) -
Luana Lorena Silva Rodrigues,
Justin Hardick,
Alcina F. Nicol,
Mariza G. Morgado,
Katrini Guidolini Martinelli,
Vanessa Salete de Paula,
José Henrique Pilotto,
Charlotte A. Gaydos
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0215001
Subject(s) - chlamydia trachomatis , mycoplasma genitalium , trichomonas vaginalis , medicine , coinfection , chlamydia , neisseria gonorrhoeae , gonorrhea , syphilis , gynecology , virology , obstetrics , human immunodeficiency virus (hiv) , immunology , biology , microbiology and biotechnology
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.