Sexually transmitted infections among HIV-infected and HIV-uninfected women in the Tapajós region, Amazon, Brazil: Self-collected vs. clinician-collected samples.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Chlamydia Infections*/epidemiology ; Chlamydia Infections*/microbiology ; Chlamydia Infections*/virology ; Coinfection*/epidemiology ; Coinfection*/microbiology ; Coinfection*/virology ; Gonorrhea*/epidemiology ; Gonorrhea*/microbiology ; Gonorrhea*/virology ; HIV Infections*/epidemiology ; HIV Infections*/microbiology ; HIV Infections*/virology ; Mycoplasma Infections*/epidemiology ; Mycoplasma Infections*/microbiology ; Mycoplasma Infections*/virology ; Papillomavirus Infections*/epidemiology ; Papillomavirus Infections*/microbiology ; Papillomavirus Infections*/virology ; Specimen Handling* ; Trichomonas Vaginitis*/epidemiology ; Trichomonas Vaginitis*/microbiology ; Trichomonas Vaginitis*/virology; Adolescent ; Adult ; Brazil/epidemiology ; Cervix Uteri/microbiology ; Cervix Uteri/virology ; Chlamydia trachomatis ; Cross-Sectional Studies ; Female ; HIV-1 ; Humans ; Mass Screening ; Middle Aged ; Mycoplasma genitalium ; Neisseria gonorrhoeae ; Papillomaviridae ; Trichomonas vaginalis

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.
Competing Interests: The authors have declared that no competing interests exist.

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U54 EB007958 United States EB NIBIB NIH HHS; UM1 AI068613 United States AI NIAID NIH HHS

Date Created: 20190424 Date Completed: 20191220 Latest Revision: 20240216

20240216

PMC6478302

10.1371/journal.pone.0215001

31013277