P138 High STI prevalence among HIV-exposed women planning for pregnancy in rural, southwestern uganda. (14th July 2019)

• Record Type: Journal Article
• Authors: Chitneni, Pooja; Bwana, Mwebesa Bosco; Owembabazi, Moran; O'Neil, Kasey; Tukwasibwe, Deogratious; Najjuma, Alice; Kyampire, Cathy; Natukynda, Sylvia; Byamukama, Adolf; Mbalibulha, Yona; Kalyebara, Paul Kato; Kaida, Angela; Matthews, Lynn
• Is Part Of: Sexually transmitted infections. Volume 95(2019)Supplement 1
• Page Start: A121
• Page End: A121
• Publication Date: 2019-07-14
• Subjects: HIV; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2019-sti.306
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Background: Many HIV-affected couples desire children. STIs increase risks of infertility, poor maternal and infant outcomes, and HIV acquisition. We introduced STI testing in southwestern Uganda to characterize STI epidemiology among HIV-exposed women planning for pregnancy. Methods: The Healthy Families PrEP study is enrolling 150 HIV-uninfected women planning for pregnancy with a partner known or suspected to be living with HIV. At enrollment, women are offered comprehensive safer conception counseling, including TDF/FTC as PrEP. We integrated STI testing for Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), Trichomonas vaginalis (TV) (via GeneXpert), and Syphilis (via immunochromatographic rapid testing confirmed by RPR). We calculated STI prevalence and compared differences among women with and without STI (Fisher's exact test). Results: Between June 2018 and January 2019, 63 women completed baseline STI testing. Median age was 28 (IQR 24–31) years. Seventeen participants (27%) had STIs, including CT-14%, NG-3%, TV-8%, Syphilis-6%, and 5% with two STIs. Women with STI were less likely to report prior pregnancy (13/17 (76%) vs. 45/46 (98%), p=0.02) and trended towards being more likely to report prior stillbirth (4/17 (24%) vs. 3/46 (7%), p=0.08). Women with STI were less likely to report having relationship power to negotiate condom use (7/17 (41%) vs. 27/46 (59%), p=0.26) and were younger (median age 26 vs. 29). PrEP uptake was high in both groups (16/17 (94%) vs. 42/46 (91%), p=1). Conclusion: We describe a 27% curable STI prevalence among HIV-exposed women planning for pregnancy. Women with STI were less likely to have had a prior pregnancy and trended towards prior stillbirth, possibly due to undiagnosed STI. In an HIV-endemic setting with social pressures to conceive children, infertility may contribute to increased HIV and STI exposures and prevalence. These data highlight the importance of integrating STI testing into HIV prevention programs to maximize the health of women, children, and families. Disclosure: No significant relationships.