High Prevalence and Incidence of Asymptomatic Sexually Transmitted Infections During Pregnancy and Postdelivery in KwaZulu Natal, South Africa. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Moodley, Dhayendre; Moodley, Prashini; Sebitloane, Motshedisi; Soowamber, Deepak; McNaughton-Reyes, Heather Luz; Groves, Allison K.; Maman, Suzanne
• Is Part Of: Sexually transmitted diseases. Volume 42:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: Sexually transmitted diseases -- Periodicals; Sexual health -- Periodicals; 616.951005
• DOI: 10.1097/OLQ.0000000000000219
• Languages: English
• ISSNs: 0148-5717

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background</title> <p>We report the prevalence and incidence of 3 treatable sexually transmitted pathogens (<italic>Neiserria gonorrhoeae</italic>, <italic>Chlamydia trachomatis</italic>, and <italic>Trichomonas vaginalis</italic>) in women who were HIV infected or at high risk for HIV infection, in pregnancy and postpartum, respectively.</p> </sec> <sec> <title>Method</title> <p>Vulvovaginal specimens collected at the first antenatal visit and again at 14 weeks postpartum were tested for <italic>N. gonorrhoeae</italic>, <italic>C. trachomatis</italic>, and <italic>T. vaginalis</italic> in the laboratory. Women were routinely tested for HIV-1 with a point-of-care test.</p> </sec> <sec> <title>Results</title> <p>Among 1480 women, 32.3% (95% confidence interval, 29.9–34.7) tested positive for any of the sexually transmitted infections (STIs) in pregnancy and 19.2% (95% confidence interval, 16.9–21.5) were positive when retested 14 weeks postpartum (incidence rate, 79.2 per 100 person-years). The prevalence of <italic>N. gonorrhoeae</italic> and <italic>T. vaginalis</italic> infections in pregnancy and the incidence rate of any STI at 14 weeks postpartum were significantly higher in HIV-1–infected women (<italic>P</italic> < 0.0001 amd <italic>P</italic> = 0.0079). More than 50% of <italic>N. gonorrhoeae</italic>, <italic>T. vaginalis</italic>, and <italic>C. trachomatis</italic> infections in pregnancy were asymptomatic.</p> </sec> <sec> <title>Conclusions</title> <p>The high prevalence of asymptomatic STIs in pregnancy is compelling evidence that demands the development and validation of point-of-care tests for STIs be expedited. In addition, the high incidence of STIs 3 months postpartum suggests that women in this study setting resume unprotected sexual intercourse soon after delivery.</p> </sec> </abstract>