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Open Access Highly Accessed Research article

Sexually transmitted infections among HIV-infected women in Thailand

Suvanna Asavapiriyanont1, Rangsima Lolekha2*, Anuvat Roongpisuthipong3, Amornpan Wiratchai4, Surasak Kaoiean1, Orapin Suksripanich2, Amphan Chalermchockcharoenkit3, Jaruensook Ausavapipit4, Somporn Srifeungfung3, Sarika Pattanasin2 and Kenneth A Katz25

Author Affiliations

1 Rajavithi Hospital, Bangkok, Thailand

2 Thailand Ministry of Public Health - US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand

3 Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand

4 Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand

5 Global AIDS Program, US Centers for Disease Control and Prevention, Atlanta, GA, USA

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BMC Public Health 2013, 13:373  doi:10.1186/1471-2458-13-373

Published: 22 April 2013

Abstract

Background

Data on sexually transmitted infections (STI) prevalence among HIV-infected women in Thailand are limited. We studied, among HIV-infected women, prevalence of STI symptoms and signs; prevalence and correlates of having any STI; prevalence and correlates of Chlamydia trachomatis (CT) or Neisseria gonorrhoeae (GC) among women without CT and/or GC symptoms or signs; and number of women without CT and/or GC symptoms or signs needed to screen (NNS) to detect one woman with CT and/or GC overall, among pregnant women, and among women ≤25 years.

Methods

During October 2004–September 2006, HIV-infected women at 3 obstetrics and gynecology clinics were asked about sexual behaviors and STI symptoms, physically examined, and screened for chlamydia, gonorrhea, trichomoniasis, and syphilis. Multivariate logistic regression was used to identify correlates of infections. NNS was calculated using standard methods.

Results

Among 1,124 women, 526 (47.0%) had STI symptoms or signs, 469 (41.7%) had CT and/or GC symptoms or signs, and 133 (11.8%) had an STI. Correlates of having an STI included pregnancy and having STI signs. Among 469 women and 655 women with vs. without CT and/or GC symptoms or signs, respectively, 43 (9.2%) vs. 31 (4.7%), 2 (0.4%) vs. 9 (1.4%), and 45 (9.6%) vs. 38 (5.8%) had CT, GC, or “CT or GC”, respectively; correlates included receiving care at university hospitals and having sex with a casual partner within 3 months. NNS for women overall and women ≤25 years old were 18 (95% CI, 13-25) and 11 (95% CI, 6-23), respectively; and for pregnant and non-pregnant women, 8 (95% CI, 4-24) and 19 (95% CI, 14-27), respectively.

Conclusions

STI prevalence among HIV-infected women, including CT and GC among those without symptoms or signs, was substantial. Screening for CT and GC, particularly for pregnant women, should be considered.

Keywords:
HIV-infected women; STI prevalence; Number needed to screen; Chlamydia; Gonorrhea; Thailand