High prevalence and incidence of asymptomatic sexually transmitted infections during pregnancy and postdelivery in KwaZulu Natal, South Africa.

Abstract:

BACKGROUND:We report the prevalence and incidence of 3 treatable sexually transmitted pathogens (Neiserria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis) in women who were HIV infected or at high risk for HIV infection, in pregnancy and postpartum, respectively. METHOD:Vulvovaginal specimens collected at the first antenatal visit and again at 14 weeks postpartum were tested for N. gonorrhoeae, C. trachomatis, and T. vaginalis in the laboratory. Women were routinely tested for HIV-1 with a point-of-care test. RESULTS: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 N. gonorrhoeae and T. vaginalis infections in pregnancy and the incidence rate of any STI at 14 weeks postpartum were significantly higher in HIV-1-infected women (P < 0.0001 amd P = 0.0079). More than 50% of N. gonorrhoeae, T. vaginalis, and C. trachomatis infections in pregnancy were asymptomatic. CONCLUSIONS: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.

journal_name

Sex Transm Dis

authors

Moodley D,Moodley P,Sebitloane M,Soowamber D,McNaughton-Reyes HL,Groves AK,Maman S

doi

10.1097/OLQ.0000000000000219

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

43-7

issue

1

eissn

0148-5717

issn

1537-4521

pii

00007435-201501000-00010

journal_volume

42

pub_type

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